Provider Demographics
NPI:1710155015
Name:TODOR, ANASTASSIA V
Entity Type:Individual
Prefix:
First Name:ANASTASSIA
Middle Name:V
Last Name:TODOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANASTASSIA
Other - Middle Name:V
Other - Last Name:TODOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5920 MCINTYRE ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-7445
Mailing Address - Country:US
Mailing Address - Phone:303-949-1250
Mailing Address - Fax:
Practice Address - Street 1:5920 MCINTYRE ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-7445
Practice Address - Country:US
Practice Address - Phone:303-949-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301085483207R00000X
CODR.0046895208M00000X
CO46895207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09753079Medicaid
CO023926OtherKAISER COMMERCIAL NUMBER
CO09753079Medicaid
COCO301384Medicare PIN
CO321836YK5YMedicare PIN