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Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Organization
INTERMOUNTAIN MEDICAL GROUP DENVER, LLC
Active
Parent organization
INTERMOUNTAIN FRONT RANGE, INC.
Other names
Intermountain Health Heart & Vascular - Wheat Ridge Cardiac & Thorasci
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP FINANCE MEDICAL GROUP)
(303) 272-0231
Entity
Organization
Contact information
Practice address
3555 LUTHERAN PKWY STE 380, WHEAT RIDGE, CO 80033-6023
(303) 403-6450
(303) 403-6087
Mailing address
3555 LUTHERAN PKWY STE 380, WHEAT RIDGE, CO 80033-6023
(303) 403-6450
(303) 403-6087
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
NULL
Other
Enumeration date
09/02/2020
Last updated
06/28/2024
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