Provider Demographics
NPI:1669652335
Name:PIERACCI, FREDRIC MICHAEL (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:FREDRIC
Middle Name:MICHAEL
Last Name:PIERACCI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:MC0206
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4507
Mailing Address - Country:US
Mailing Address - Phone:303-436-4029
Mailing Address - Fax:303-436-6572
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:MC0206
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-4029
Practice Address - Fax:303-436-6572
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232755208600000X
CO48205207RB0002X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery