Healthcare Provider Details

I. General information

NPI: 1992339790
Provider Name (Legal Business Name): PREMIER FAMILY MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2283 S MONACO PKWY STE 105
DENVER CO
80222-5845
US

IV. Provider business mailing address

2283 S MONACO PKWY STE 105
DENVER CO
80222-5845
US

V. Phone/Fax

Practice location:
  • Phone: 720-531-2370
  • Fax: 720-531-2370
Mailing address:
  • Phone: 720-531-2370
  • Fax: 720-531-2370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISBAH DARWEESH ZMILY
Title or Position: OWNER
Credential: MD
Phone: 720-531-2370