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Individual

ANDREAS MYKONIATIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1719 E 19TH AVE, IM HOSPITALIST, DENVER, CO 80218-1235
(720) 754-2296
(844) 669-1725
Mailing address
5600 S QUEBEC STREET, SUITE 312A, GREENWOOD VILLIAGE, CO 80111-2208
(720) 754-2296
(844) 669-1725

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036119322
IL
207R00000X
Internal Medicine Physician
DR.0056350
CO
208M00000X
Hospitalist Physician
036119322
IL
208M00000X
Hospitalist Physician
Primary
56350
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
58685057
CO
01
F400291996
MEDICARE PTAN
Enumeration date
05/25/2007
Last updated
06/29/2021
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