Organization
PRESBYTERIAN DENVER EKG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK MILLER MD (MANAGING PARTNER)
(720) 917-7052
Entity
Organization
Contact information
Practice address
1719 E 19TH AVE, DENVER, CO 80218-1235
(720) 917-7052
Mailing address
3464 S WILLOW ST, 176, DENVER, CO 80231-4531
(303) 755-2900
(303) 755-0404
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04004230
—
CO
01
—
CQ5074
RAILROAD MEDICARE
CO
01
—
PRS1008
BLUE SHIELD
CO
Enumeration date
05/03/2006
Last updated
03/28/2011
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