Provider Demographics
NPI:1710904495
Name:DENVER SPINE INSTITUTE PC
Entity Type:Organization
Organization Name:DENVER SPINE INSTITUTE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EIPE
Authorized Official - Middle Name:
Authorized Official - Last Name:KURUVILA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-456-4466
Mailing Address - Street 1:7259 W ALASKA DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3228
Mailing Address - Country:US
Mailing Address - Phone:303-456-4466
Mailing Address - Fax:303-456-4561
Practice Address - Street 1:7259 W ALASKA DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3228
Practice Address - Country:US
Practice Address - Phone:303-456-4466
Practice Address - Fax:303-456-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC804550Medicare PIN