Provider Demographics
NPI:1891842423
Name:DENVER ENDOCRINOLOGY DIABETES AND METABOLISM
Entity Type:Organization
Organization Name:DENVER ENDOCRINOLOGY DIABETES AND METABOLISM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BLICHARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-221-4335
Mailing Address - Street 1:10099 RIDGEGATE PKWY
Mailing Address - Street 2:CONIFER BLDG. SUITE 210
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5531
Mailing Address - Country:US
Mailing Address - Phone:720-221-4335
Mailing Address - Fax:720-221-3683
Practice Address - Street 1:10099 RIDGEGATE PKWY
Practice Address - Street 2:CONIFER BLDG. SUITE 210
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5531
Practice Address - Country:US
Practice Address - Phone:720-221-4335
Practice Address - Fax:720-221-3683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44824207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G18470Medicare UPIN