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General NPI Number Information
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NPI Number | 1316064330
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Entity Type | Organization
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Legal Business Name | DENVER INFECTIOUS DISEASE CONSULTANTS, PLLC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 06/17/2010
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Provider Practice Location Address
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Address Line | 4545 E 9TH AVE SUITE 120
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City | DENVER
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State | CO
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Zip | 80220-3901
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Country | US
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Telephone | 303-393-8050
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Fax | 303-320-1953
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Provider Business Mailing Address
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Address Line | 4545 E 9TH AVE SUITE 120
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City | DENVER
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State | CO
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Zip | 80220-3901
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Country | US
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Telephone | 303-393-8050
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Fax | 303-320-1953
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH GREENBERG
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Credential | D.O.
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Telephone | 303-393-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 32546
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License Number State | CO
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