Provider Demographics
NPI:1639116130
Name:METRO DIAGNOSTICS & ANESTHESIA
Entity Type:Organization
Organization Name:METRO DIAGNOSTICS & ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:M
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-256-6467
Mailing Address - Street 1:4600 S SYRACUSE ST
Mailing Address - Street 2:STE 932
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2750
Mailing Address - Country:US
Mailing Address - Phone:303-256-6467
Mailing Address - Fax:303-256-6469
Practice Address - Street 1:4600 S SYRACUSE ST
Practice Address - Street 2:STE 932
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2750
Practice Address - Country:US
Practice Address - Phone:303-256-6467
Practice Address - Fax:303-256-6469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
801773Medicare ID - Type Unspecified