Healthcare Provider Details

I. General information

NPI: 1265662860
Provider Name (Legal Business Name): SOUTH DENVER PRIMARY CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 07/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9620 E ARAPAHOE RD
GREENWOOD VILLAGE CO
80112-3703
US

IV. Provider business mailing address

9620 E ARAPAHOE RD
GREENWOOD VILLAGE CO
80112-3703
US

V. Phone/Fax

Practice location:
  • Phone: 303-835-9915
  • Fax: 303-320-5399
Mailing address:
  • Phone: 303-835-9915
  • Fax: 303-320-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN SCHNURR
Title or Position: PHYSICIAN/PRESIDENT
Credential: D.O.
Phone: 303-835-9915