Provider Demographics
NPI:1649306390
Name:PREECE, MICHAEL T (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:PREECE
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 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:10800 E GEDDES AVE STE 300
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-3895
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD174932085R0202X
TN543012085R0202X
CO498462085N0700X
KS04-349342085R0202X
NE261472085R0202X
MAL-2275522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO49001779Medicaid
TN1528962Medicaid
IL1649306390Medicaid
SD1649306390Medicaid
NV1649306390Medicaid
MT1649306390Medicaid
KS200869030AMedicaid
AZ860155Medicaid
WA0302451Medicaid
UT1649306390Medicaid
CA1649306390Medicaid
WY1649306390Medicaid
IA1649306390Medicaid
OK200653220AMedicaid
NV1649306390Medicaid
NENA2517007Medicare PIN
COCOAAA1595Medicare PIN
COP01002821Medicare PIN
COCOAAA1596Medicare PIN
NECOA106448Medicare PIN
KS111257031Medicare PIN
OK200653220AMedicaid
SD1649306390Medicaid
COP01001202Medicare PIN
KSKA3249013Medicare PIN
CO394116ZLJ3Medicare PIN