# INTERMOUNTAIN MEDICAL GROUP DENVER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTERMOUNTAIN FRONT RANGE, INC.
- **Other names:** Intermountain Health Heart & Vascular - Wheat Ridge Cardiac & Thorasci
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1831703222
- **Legal business name:** INTERMOUNTAIN FRONT RANGE, INC.
- **Authorized official:** JON MCDANIEL (VP FINANCE MEDICAL GROUP)
- **Authorized official phone:** (303) 272-0231

## Contact information

- **Practice address:** 3555 LUTHERAN PKWY STE 380, WHEAT RIDGE, CO 80033-6023
- **Practice address phone:** (303) 403-6450
- **Practice address fax:** (303) 403-6087
- **Mailing address:** 3555 LUTHERAN PKWY STE 380, WHEAT RIDGE, CO 80033-6023
- **Mailing address phone:** (303) 403-6450
- **Mailing address fax:** (303) 403-6087

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/02/2020
- **Last updated:** 06/28/2024