Provider Demographics
NPI:1669457156
Name:PULMONARY CONSULTANTS OF COLARADO PC
Entity Type:Organization
Organization Name:PULMONARY CONSULTANTS OF COLARADO PC
Other - Org Name:JULIE SUTARIK MD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIANNA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:SUTARIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-860-7530
Mailing Address - Street 1:1601 E 19TH AVE
Mailing Address - Street 2:STE 6250
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1291
Mailing Address - Country:US
Mailing Address - Phone:303-860-7530
Mailing Address - Fax:303-860-1057
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:STE 6250
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1291
Practice Address - Country:US
Practice Address - Phone:303-860-7530
Practice Address - Fax:303-860-1057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO74580787Medicaid
CO74580787Medicaid