Healthcare Provider Details

I. General information

NPI: 1770745325
Provider Name (Legal Business Name): ADAM DAVE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 E 9TH AVE
DENVER CO
80262-1000
US

IV. Provider business mailing address

4200 E 9TH AVE
DENVER CO
80262-1000
US

V. Phone/Fax

Practice location:
  • Phone: 303-315-7424
  • Fax:
Mailing address:
  • Phone: 303-315-7424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2915
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: