Healthcare Provider Details

I. General information

NPI: 1538259213
Provider Name (Legal Business Name): MICHAEL R. BRISTOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 E 9TH AVE
DENVER CO
80262-0001
US

IV. Provider business mailing address

13611 E COLFAX AVE
AURORA CO
80045-5701
US

V. Phone/Fax

Practice location:
  • Phone: 303-493-7000
  • Fax:
Mailing address:
  • Phone: 303-493-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number31364
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number31364
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: