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Organization

ADVANCED EAR, NOSE & THROAT, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL R MENACHOF MD (OWNER)
(303) 792-3242
Entity
Organization

Contact information

Practice address
7400 E CRESTLINE CIR, SUITE 100, GREENWOOD VILLAGE, CO 80111-3656
(303) 792-3242
(303) 792-9403
Mailing address
7400 E CRESTLINE CIR, SUITE 100, GREENWOOD VILLAGE, CO 80111-3656
(303) 792-3242
(303) 792-9403

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
31645
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01316454
CO
01
1275724932
NPI
01
1396871265
NPI
CO
01
1710065446
NPI
CO
05
48138274
CO
Enumeration date
11/01/2006
Last updated
08/01/2014
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