Organization
BOULDER EKG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC ZACHARIAS MD (MANAGING PARTNER)
(303) 440-3083
Entity
Organization
Contact information
Practice address
3464 S WILLOW ST, DENVER, CO 80231-4531
(303) 755-2900
(303) 755-0404
Mailing address
1100 BALSAM AVE, BOULDER, CO 80304-3404
(303) 440-3083
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04014072
—
CO
01
—
BOR7208
BLUE SHIELD
CO
01
—
CD4754
RAILROAD MEDICARE
CO
Enumeration date
05/03/2006
Last updated
10/29/2007
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