Provider Demographics
NPI:1659404168
Name:APOLLO INTERNAL MEDICINE PROF LLC
Entity Type:Organization
Organization Name:APOLLO INTERNAL MEDICINE PROF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:METROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-765-3485
Mailing Address - Street 1:950 E HARVARD AVE
Mailing Address - Street 2:SUITE # 530
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-7009
Mailing Address - Country:US
Mailing Address - Phone:303-765-3485
Mailing Address - Fax:303-765-3486
Practice Address - Street 1:950 E HARVARD AVE
Practice Address - Street 2:SUITE # 530
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-7009
Practice Address - Country:US
Practice Address - Phone:303-765-3485
Practice Address - Fax:303-765-3486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31936174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC508368Medicare PIN