Provider Demographics
NPI:1689852261
Name:MILCHIKER, DAVID JORDAN
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JORDAN
Last Name:MILCHIKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 E DRY CREEK RD UNIT 8-207
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1657
Mailing Address - Country:US
Mailing Address - Phone:303-862-9388
Mailing Address - Fax:
Practice Address - Street 1:10200 E DRY CREEK RD UNIT 8-207
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1657
Practice Address - Country:US
Practice Address - Phone:303-862-9388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA5232512104100000X
CO099230901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker