Provider Demographics
NPI:1134247471
Name:ZUEHLSDORFF, GARY LOUIS (DO)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:LOUIS
Last Name:ZUEHLSDORFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7661 OAK ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-3619
Mailing Address - Country:US
Mailing Address - Phone:303-912-9891
Mailing Address - Fax:720-872-0421
Practice Address - Street 1:550 THORNTON PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2100
Practice Address - Country:US
Practice Address - Phone:303-341-1799
Practice Address - Fax:720-872-0421
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31487207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G53268Medicare UPIN