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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
Lutheran Clinic - Maternal Fetal Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTERMOUNTAIN FRONT RANGE, INC.
Authorized official
JON MCDANIEL (VP FINANCE)
(303) 272-0231
Entity
Organization
Contact information
Practice address
12905 W 40TH AVE, STE 420, WHEAT RIDGE, CO 80401
(303) 265-5670
Mailing address
500 ELDORADO BLVD STE 4300, BROOMFIELD, CO 80021-3564
(303) 272-0566
(303) 272-0390
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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