Provider Demographics
NPI:1982651329
Name:VAN DIJK, CLAUDIA M (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:M
Last Name:VAN DIJK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4891 INDEPENDENCE ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6752
Mailing Address - Country:US
Mailing Address - Phone:303-456-5495
Mailing Address - Fax:303-456-7490
Practice Address - Street 1:5265 VANCE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-3714
Practice Address - Country:US
Practice Address - Phone:303-232-3366
Practice Address - Fax:303-232-8734
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42208174400000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00330486OtherRR MEDICARE
COP00330486OtherRR MEDICARE
I44219Medicare UPIN