Healthcare Provider Details

I. General information

NPI: 1033194998
Provider Name (Legal Business Name): GREGORY M MARGOLIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 E BELLEVIEW AVE STE G10
GREENWOOD VILLAGE CO
80111-1634
US

IV. Provider business mailing address

7100 E BELLEVIEW AVE STE G10
GREENWOOD VILLAGE CO
80111-1634
US

V. Phone/Fax

Practice location:
  • Phone: 303-745-0000
  • Fax: 303-773-3675
Mailing address:
  • Phone: 303-745-0000
  • Fax: 303-773-3675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number221275-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number3894
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0045952
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: