Provider Demographics
NPI:1548566748
Name:SUSAN SAVAGE MD PC
Entity Type:Organization
Organization Name:SUSAN SAVAGE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-798-4404
Mailing Address - Street 1:9898 ROSEMONT AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-4106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9898 ROSEMONT AVE
Practice Address - Street 2:STE 103
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-4106
Practice Address - Country:US
Practice Address - Phone:303-798-4404
Practice Address - Fax:303-470-9934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO26191207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01261916Medicaid
CO01261916Medicaid