Organization
MEDICAL IMAGING OF COLORADO RADIOLOGY IMAGING ASSC PC ETAL PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUANITA SCHMUCKER (REVENUE CYCLE BILLING MANAGER)
(720) 493-3712
Entity
Organization
Contact information
Practice address
10800 E GEDDES AVE STE 300, ENGLEWOOD, CO 80112-3895
(303) 761-9190
(720) 874-4462
Mailing address
10800 E GEDDES AVE, ENGLEWOOD, CO 80112-3894
(303) 761-9190
(720) 874-4462
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074088801
—
TX
05
—
100370940A
—
KS
05
—
123484600
—
WY
01
—
18062
PRES SALUD MEDICAID MIC
—
05
—
4007803
—
CO
01
—
5797650
AETNA MIC
—
01
—
8489712601
PACIFICARE MIC
—
01
—
CC8768
RR MEDICARE MIC
—
01
—
CO1190
HEALTHNET NE MIC
—
01
—
MEW4008
BCBS MIC
—
Enumeration date
06/06/2006
Last updated
05/23/2024
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