Healthcare Provider Details

I. General information

NPI: 1134381676
Provider Name (Legal Business Name): INTERNAL MEDICINE, PULMONARY & CRITICAL CARE ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S DOWNING ST
DENVER CO
80210-5817
US

IV. Provider business mailing address

1241 W MINERAL AVE SUITE 100
LITTLETON CO
80120-5685
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-5666
  • Fax: 303-778-5787
Mailing address:
  • Phone: 303-759-0854
  • Fax: 303-759-0864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: TERESA A. LONG
Title or Position: OFFICE MANAGER
Credential:
Phone: 303-759-0854