Provider Demographics
NPI:1477570075
Name:GERSOFF, WAYNE K (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:K
Last Name:GERSOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8101 E LOWRY BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7196
Mailing Address - Country:US
Mailing Address - Phone:303-344-9090
Mailing Address - Fax:303-344-1912
Practice Address - Street 1:8101 E LOWRY BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7196
Practice Address - Country:US
Practice Address - Phone:303-344-9090
Practice Address - Fax:303-344-1912
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO28129207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01281294Medicaid
0330710001OtherDMERC
0330710001OtherDMERC
COG034-8Medicare PIN
CO200027497Medicare PIN