Provider Demographics
NPI:1740055466
Name:MONTROSE REGIONAL GASTROENTEROLOGY
Entity type:Organization
Organization Name:MONTROSE REGIONAL GASTROENTEROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANAYLST
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-252-2691
Mailing Address - Street 1:800 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4212
Mailing Address - Country:US
Mailing Address - Phone:970-240-2211
Mailing Address - Fax:
Practice Address - Street 1:630 E STAR CT
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-6702
Practice Address - Country:US
Practice Address - Phone:970-252-1020
Practice Address - Fax:970-252-1041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty