Healthcare Provider Details

I. General information

NPI: 1861671034
Provider Name (Legal Business Name): RAYMOND E GARRETT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 04/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 S FEDERAL BLVD
DENVER CO
80219-5501
US

IV. Provider business mailing address

1930 S FEDERAL BLVD
DENVER CO
80219-5501
US

V. Phone/Fax

Practice location:
  • Phone: 303-935-9142
  • Fax:
Mailing address:
  • Phone: 303-935-9142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number22872
License Number StateCO

VIII. Authorized Official

Name: RAYMOND E GARRETT
Title or Position: PRACTICE DOCTOR
Credential: MD
Phone: 303-935-9142