Organization
BOULDER VALLEY GASTROENTEROLOGY INC.
Active
Other names
Gastroenterology of the Rockies
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAUS MAHNKE M.D. (BOARD MEMBER)
(303) 604-5000
Entity
Organization
Contact information
Practice address
1000 W SOUTH BOULDER RD, SUITE 200, LAFAYETTE, CO 80026-2752
(303) 604-5000
(720) 890-0364
Mailing address
382 S ARTHUR AVE, LOUISVILLE, CO 80027-3094
(303) 604-5000
(720) 890-0364
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04004180
—
CO
01
—
CD5666
RAILROAD MEDICARE
CO
01
—
GAA1308
BCBS
CO
Enumeration date
06/24/2006
Last updated
12/11/2020
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