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General NPI Number Information
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NPI Number | 1336146026
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Entity Type | Organization
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Legal Business Name | THOMAS K. MAYEDA, M.D., PC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 7373 W JEFFERSON AVE STE 103
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City | LAKEWOOD
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State | CO
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Zip | 80235-2038
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Country | US
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Telephone | 303-989-1284
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Fax | 303-988-6229
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Provider Business Mailing Address
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Address Line | 7373 W JEFFERSON AVE STE 103
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City | LAKEWOOD
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State | CO
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Zip | 80235-2038
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Country | US
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Telephone | 303-989-1284
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Fax | 303-988-6229
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Authorized Official
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Title or Position | M.D.
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Name | DR. THOMAS K. MAYEDA
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Credential | M.D.
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Telephone | 303-989-1284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 21404
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License Number State | CO
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