Provider Demographics
NPI:1740468370
Name:OLIVIA V. ADAIR M.D., P.C.
Entity type:Organization
Organization Name:OLIVIA V. ADAIR M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:ADAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-777-1647
Mailing Address - Street 1:3535 S LAFAYETTE ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3957
Mailing Address - Country:US
Mailing Address - Phone:303-777-1647
Mailing Address - Fax:303-744-1589
Practice Address - Street 1:3535 S LAFAYETTE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3957
Practice Address - Country:US
Practice Address - Phone:303-777-1647
Practice Address - Fax:303-744-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30167207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01301670Medicaid
CO01301670Medicaid
CO811514Medicare PIN
CO811515Medicare PIN
COC95074Medicare PIN