Organization
BROADWAY MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY CARPENTER (OFFICE MANAGER)
(954) 868-1563
Entity
Organization
Contact information
Practice address
403 16TH ST, SUITE 301, DENVER, CO 80202-5026
(720) 598-9206
Mailing address
403 16TH ST, SUITE 301, DENVER, CO 80202-5026
(720) 598-9206
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0058017
CO
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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