Provider Demographics
NPI:1134206402
Name:ELDER, MICHAEL PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:ELDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:19641 E PARKER SQUARE DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7399
Mailing Address - Country:US
Mailing Address - Phone:303-840-3800
Mailing Address - Fax:303-840-8442
Practice Address - Street 1:19641 E PARKER SQUARE DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7399
Practice Address - Country:US
Practice Address - Phone:303-805-3800
Practice Address - Fax:303-805-8442
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO32721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01327212Medicaid
CO01327212Medicaid
CO501348Medicare PIN