Provider Demographics
NPI:1710088687
Name:SCHREIBER, ALLEN JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:JAY
Last Name:SCHREIBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 E BELLEVIEW AVE
Mailing Address - Street 2:SUITE 326C
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2803
Mailing Address - Country:US
Mailing Address - Phone:303-321-1095
Mailing Address - Fax:303-321-4717
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 326C
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2803
Practice Address - Country:US
Practice Address - Phone:303-321-1095
Practice Address - Fax:303-321-4717
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23518261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2289182Medicare PIN