Provider Demographics
NPI:1659338762
Name:MCGOULD, MICHELE M (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:MCGOULD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E HAMPDEN AVE
Mailing Address - Street 2:# 370
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3781
Mailing Address - Country:US
Mailing Address - Phone:303-788-7888
Mailing Address - Fax:303-788-7592
Practice Address - Street 1:601 E HAMPDEN AVE
Practice Address - Street 2:# 370
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3781
Practice Address - Country:US
Practice Address - Phone:303-788-7888
Practice Address - Fax:303-788-7592
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40648207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07171536Medicaid
G51863Medicare UPIN
C523488Medicare PIN
P00600614Medicare PIN