Provider Demographics
NPI:1609125434
Name:GAITER, MARKUS LEROY
Entity Type:Individual
Prefix:MR
First Name:MARKUS
Middle Name:LEROY
Last Name:GAITER
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 1:1175 ALBION ST
Mailing Address - Street 2:APT #210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2366
Mailing Address - Country:US
Mailing Address - Phone:720-217-2702
Mailing Address - Fax:
Practice Address - Street 1:4455 E 12TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2415
Practice Address - Country:US
Practice Address - Phone:303-504-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical