Individual
DR. MAX CHRISTOPHER BASTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14701 E EXPOSITION AVE, AURORA, CO 80012-2623
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0055160
CO
390200000X
Student in an Organized Health Care Education/Training Program
TL-4510
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026191
KAISER COMMERCIAL NUMBER
CO
05
—
92658873
—
CO
Enumeration date
07/03/2012
Last updated
06/04/2021
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