Provider Demographics
NPI:1619992542
Name:MAURICIO WAINTRUB, M.D., P.C.
Entity Type:Organization
Organization Name:MAURICIO WAINTRUB, M.D., P.C.
Other - Org Name:STRASBURG CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:WAINTRUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-337-5575
Mailing Address - Street 1:56441 E COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:CO
Mailing Address - Zip Code:80136-7741
Mailing Address - Country:US
Mailing Address - Phone:303-622-9241
Mailing Address - Fax:303-622-6880
Practice Address - Street 1:56441 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:CO
Practice Address - Zip Code:80136-7741
Practice Address - Country:US
Practice Address - Phone:303-622-9241
Practice Address - Fax:303-622-6880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34568207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty