Provider Demographics
NPI:1952307829
Name:PTASNIK, MICHAEL J (MD,FACC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:PTASNIK
Suffix:
Gender:M
Credentials:MD,FACC
Other - Prefix:
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Mailing Address - Street 1:11700 W 2ND PL
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1710
Mailing Address - Country:US
Mailing Address - Phone:303-595-2727
Mailing Address - Fax:303-595-2626
Practice Address - Street 1:11700 W 2ND PL
Practice Address - Street 2:SUITE 350
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1710
Practice Address - Country:US
Practice Address - Phone:303-595-2727
Practice Address - Fax:303-595-2626
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2013-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO20647207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01206473Medicaid
COD23814Medicare UPIN
300797Medicare UPIN