Provider Demographics
NPI:1477564524
Name:DENVER DERMATOLOGY CONSULTANTS PC
Entity Type:Organization
Organization Name:DENVER DERMATOLOGY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:YAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-426-4525
Mailing Address - Street 1:1551 MILKY WAY
Mailing Address - Street 2:DENVER DERMATOLOGY CONSULTANTS PC
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-4713
Mailing Address - Country:US
Mailing Address - Phone:303-426-4525
Mailing Address - Fax:303-428-6381
Practice Address - Street 1:1551 MILKY WAY
Practice Address - Street 2:DENVER DERMATOLOGY CONSULTANTS PC
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-4713
Practice Address - Country:US
Practice Address - Phone:303-426-4525
Practice Address - Fax:303-428-6381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCB8608Medicare PIN