MEDICARE: INFECTIOUS DISEASE CONSULT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	26323	OTHER	CO	LICENSE

General Provider Information

NPI Number	:	1194702084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFECTIOUS DISEASE CONSULT

Provider Business Mailing Address
First Line	:	1601 E 19TH AVE STE 3700
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1220
Country	:	US
Telephone Number	:	303-831-4774
Fax Number	:	303-839-7750

Provider Business Practice Location Address
First Line	:	1601 E 19TH AVE STE 3700
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1220
Country	:	US
Telephone Number	:	303-831-4774
Fax Number	:	303-839-7750

Authorized Official
Title or Position	:	M.D.
Name	:	DR. RAYMOND N. BLUM
Credential	:	M.D.
Telephone Number	:	303-831-4774

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	10/30/2024

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Directions to “INFECTIOUS DISEASE CONSULT ” Practice Location

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