Provider Demographics
NPI:1477958445
Name:GUR, RAVID MOSHE (BA)
Entity Type:Individual
Prefix:
First Name:RAVID
Middle Name:MOSHE
Last Name:GUR
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:MOSES
Other - Middle Name:
Other - Last Name:GUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4455 E. 12TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221
Mailing Address - Country:US
Mailing Address - Phone:919-906-7258
Mailing Address - Fax:
Practice Address - Street 1:4455 E. 12TH AVENUE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221
Practice Address - Country:US
Practice Address - Phone:303-504-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program