1881814051 NPI number — DR. PETER MICHAEL PETROPULOS DC

Table of content: DR. PETER MICHAEL PETROPULOS DC (NPI 1881814051)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881814051 NPI number — DR. PETER MICHAEL PETROPULOS DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PETROPULOS
Provider First Name:
PETER
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
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:
1881814051
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12476 GREENLAND ACRES RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LARKSPUR
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80118-6130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-681-2523
Provider Business Mailing Address Fax Number:
303-689-0187

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7200 E. DRY CREEK RD.
Provider Second Line Business Practice Location Address:
SUITE A101
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-850-0880
Provider Business Practice Location Address Fax Number:
303-689-0387
Provider Enumeration Date:
04/27/2007

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: 111NN1001X , with the licence number:  2292 , 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)





Copyright © 2007-2025 www.npivalidator.com