Healthcare Provider Details

I. General information

NPI: 1609308287
Provider Name (Legal Business Name): BRYAN GOLUBSKI M.D. (05/2017)
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 ROCKY MOUNTAIN AVE STE 120
LOVELAND CO
80538-8717
US

IV. Provider business mailing address

3702 S TIMBERLINE RD STE A
FORT COLLINS CO
80525-3625
US

V. Phone/Fax

Practice location:
  • Phone: 970-669-5432
  • Fax: 970-207-1893
Mailing address:
  • Phone: 970-207-9773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number0074542
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: