Healthcare Provider Details
I. General information
NPI: 1467029256
Provider Name (Legal Business Name): EKG ASSOCIATES PROF LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2021
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4567 E 9TH AVE
DENVER CO
80220-3908
US
IV. Provider business mailing address
3464 S WILLOW ST STE 179
DENVER CO
80231-4531
US
V. Phone/Fax
- Phone: 303-755-2900
- Fax:
- Phone: 303-755-2900
- Fax: 303-755-0404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
J
PTASNIK
Title or Position: PRESIDENT
Credential:
Phone: 303-522-3785