Healthcare Provider Details

I. General information

NPI: 1396871265
Provider Name (Legal Business Name): MICHAEL R MENACHOF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6110 GREENWOOD PLAZA BLVD
GREENWOOD VILLAGE CO
80111-4803
US

IV. Provider business mailing address

6110 GREENWOOD PLAZA BLVD
GREENWOOD VILLAGE CO
80111-4803
US

V. Phone/Fax

Practice location:
  • Phone: 303-792-3242
  • Fax: 303-792-9403
Mailing address:
  • Phone: 303-792-3242
  • Fax: 303-792-9403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number31645
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number31645
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number31645
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: