Provider Demographics
NPI:1700661477
Name:CALONGE, BRUCE NEDROW (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:NEDROW
Last Name:CALONGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NED
Other - Middle Name:
Other - Last Name:CALONGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6506 E PROGRESS CIR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1620
Mailing Address - Country:US
Mailing Address - Phone:303-902-7765
Mailing Address - Fax:
Practice Address - Street 1:4300 CHERRY CREEK DRIVE SOUTH
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:720-877-2372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO275212083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine