Organization
CHERRY CREEK PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY L MATHIE M.D. (OWNER/PHYSICIAN)
(303) 756-0101
Entity
Organization
Contact information
Practice address
4900 E KENTUCKY AVE, DENVER, CO 80246-2365
(303) 756-0101
(303) 756-1408
Mailing address
4900 E KENTUCKY AVE, DENVER, CO 80246-2365
(303) 756-0101
(303) 756-1408
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24963
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54388074
—
CO
Enumeration date
04/18/2006
Last updated
08/22/2020
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