Healthcare Provider Details

I. General information

NPI: 1114989332
Provider Name (Legal Business Name): CONSTANTINE JOHN TSAMASFYROS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 STEELE ST #300
DENVER CO
80206-5219
US

IV. Provider business mailing address

128 STEELE ST #300
DENVER CO
80206-5219
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-2005
  • Fax: 303-322-4408
Mailing address:
  • Phone: 303-322-2005
  • Fax: 303-322-4408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17165
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: