Healthcare Provider Details

I. General information

NPI: 1952038259
Provider Name (Legal Business Name): COLORADO CARDIOVASCULAR SURGICAL ASSOCIATES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 HALE PKWY STE 340
DENVER CO
80220-4024
US

IV. Provider business mailing address

500 E HAMPDEN AVE STE 204
ENGLEWOOD CO
80113-2885
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-6527
  • Fax: 303-733-1288
Mailing address:
  • Phone: 303-778-6527
  • Fax: 303-733-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAWNYA S WARTELL
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 303-778-6527