Healthcare Provider Details

I. General information

NPI: 1649762931
Provider Name (Legal Business Name): MICHAEL ZEV NEVID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 JACKSON ST
DENVER CO
80206-2761
US

IV. Provider business mailing address

4637 PERRY ST
DENVER CO
80212-2551
US

V. Phone/Fax

Practice location:
  • Phone: 877-225-5654
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0066153
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: