Organization
SOUTH DENVER PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRIY I PALES DO (SOLE MEMBER)
(720) 441-4410
Entity
Organization
Contact information
Practice address
13111 E BRIARWOOD AVE, #370, CENTENNIAL, CO 80112
(720) 441-4410
(888) 474-7158
Mailing address
13111 E BRIARWOOD AVE, SUITE #370, CENTENNIAL, CO 80112-3930
(720) 441-4410
(888) 474-7158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
46797
CO
2084N0400X
Neurology Physician
47080
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148761
—
CO
Enumeration date
05/03/2013
Last updated
03/13/2014
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