Provider Demographics
NPI:1922099464
Name:FINTA, BOHUSLAV (MD)
Entity Type:Individual
Prefix:DR
First Name:BOHUSLAV
Middle Name:
Last Name:FINTA
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 1:8222 W EASTMAN PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-6238
Mailing Address - Country:US
Mailing Address - Phone:616-915-7915
Mailing Address - Fax:
Practice Address - Street 1:3655 LUTHERAN PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6018
Practice Address - Country:US
Practice Address - Phone:303-603-9800
Practice Address - Fax:303-403-6209
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064852207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4713838Medicaid
MIOD17643042Medicare ID - Type Unspecified
MIP00150554OtherRAILROAD MEDICARE
4548517OtherECFMG
MIG32561Medicare UPIN