Intermountain Medical Group Denver, LLC
Psychiatry & Neurology, Neurology in Denver, CO. Organization (NPI-2).
NPI number1104574409
StatusActive
Last updated in NPPESJun 28, 2024
Details
- NPI
- 1104574409
- Entity type
- Organization (NPI-2)
- Legal business name
- Intermountain Medical Group Denver, LLC
- Organization subpart
- Yes
- Enumeration date
- Mar 15, 2022
- Certification date
- Jun 28, 2024
- Last updated
- Jun 28, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | – | – | Yes |
| 207WX0109X | Ophthalmology, Neuro-ophthalmology | – | – |
Other names
- Rampart Clinic Neurology & Neuro-Ophthamology (Doing Business As)
Practice location
130 Rampart Way Ste 150Denver, CO 80230-6442
Phone 303-812-6930 · Fax 303-318-2477
Mailing address
500 Eldorado Blvd Ste 4300Broomfield, CO 80021-3564
Authorized official
Jon McDaniel
Vp Finance
3032720231
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