Provider Demographics
NPI:1518290501
Name:MCLAREN, GRETA MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:GRETA
Middle Name:MICHELLE
Last Name:MCLAREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GRETA
Other - Middle Name:MICHELLE
Other - Last Name:THIELEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6950 E BELLEVIEW AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1624
Mailing Address - Country:US
Mailing Address - Phone:303-770-7546
Mailing Address - Fax:303-770-0311
Practice Address - Street 1:6950 E BELLEVIEW AVE STE 102
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1624
Practice Address - Country:US
Practice Address - Phone:303-770-7546
Practice Address - Fax:303-770-0311
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE95469Medicare UPIN