1124052675 NPI number — DAVID DRUCKER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124052675 NPI number — DAVID DRUCKER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DRUCKER
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124052675
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1255 19TH ST
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80202-1459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-293-9311
Provider Business Mailing Address Fax Number:
303-293-8028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1255 19TH ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80202-1459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-293-9311
Provider Business Practice Location Address Fax Number:
303-293-8028
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  20580 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0793502 . This is a "AETNA" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 118650534030 . This is a "HUMANA" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 181542901 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 01340132 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01205806 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0401163 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0533470 . This is a "CIGNA" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 920421020632 . This is a "PACIFICARE COLORADO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 26501 . This is a "BLUE CROSS" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 840857121001 . This is a "ROCKY MOUNTAIN HMO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com