Provider Demographics
NPI:1689789414
Name:GOLLUB, MATTHEW I (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:I
Last Name:GOLLUB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2055 N HIGH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5503
Mailing Address - Country:US
Mailing Address - Phone:303-839-7440
Mailing Address - Fax:303-839-7210
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-0001
Practice Address - Country:US
Practice Address - Phone:520-694-8888
Practice Address - Fax:520-626-6571
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2016-09-19
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Provider Licenses
StateLicense IDTaxonomies
CO457302080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine