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NPI Code Detail

MEDICARE: MR. MICHAEL PERSOFF MD

MEDICARE:  MR. MICHAEL  PERSOFF  MD
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
1207RN0300XNephrology Physician16080CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336132638
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL PERSOFF MD
Provider Business Mailing Address
First Line : 950 E HARVARD AVE
Second Line : SUITE 240
City : DENVER
State : CO
Zip : 80210-7009
Country : US
Telephone Number : 303-871-0977
Fax Number : 303-733-2387
Provider Business Practice Location Address
First Line : 950 E HARVARD AVE
Second Line : SUITE 240
City : DENVER
State : CO
Zip : 80210-7009
Country : US
Telephone Number : 303-871-0977
Fax Number : 303-733-2387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 07/08/2007

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Directions to “ MR. MICHAEL PERSOFF MD” Practice Location

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