Provider Demographics
NPI:1568663227
Name:OAKES, MICHAEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:OAKES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 BANNOCK ST
Mailing Address - Street 2:STE 300
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4028
Mailing Address - Country:US
Mailing Address - Phone:303-716-3787
Mailing Address - Fax:303-716-3777
Practice Address - Street 1:938 BANNOCK ST
Practice Address - Street 2:STE 300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4028
Practice Address - Country:US
Practice Address - Phone:303-716-3787
Practice Address - Fax:303-716-3777
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010814842085R0202X
CO477542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO304848Medicare PIN
COP00805881Medicare PIN
COP00739327Medicare PIN
COCO304849Medicare PIN