Provider Demographics
NPI:1467473355
Name:THERESA A SCHOLZ MD PC LLC
Entity Type:Organization
Organization Name:THERESA A SCHOLZ MD PC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-755-2900
Mailing Address - Street 1:3464 S WILLOW ST
Mailing Address - Street 2:SUITE 658
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4531
Mailing Address - Country:US
Mailing Address - Phone:303-755-2900
Mailing Address - Fax:
Practice Address - Street 1:4545 E 9TH AVE STE 220
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3909
Practice Address - Country:US
Practice Address - Phone:303-329-4840
Practice Address - Fax:303-329-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COTH664050OtherBLUE SHIELD
COTH664050OtherBLUE SHIELD