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General NPI Number Information
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NPI Number | 1386964377
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Entity Type | Individual
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Provider Name | MICHELLE B MCCLOSKEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 400 S MCCASLIN BLVD STE 103
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City | LOUISVILLE
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State | CO
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Zip | 80027-9701
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Country | US
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Telephone | 303-319-5283
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Fax | 303-666-7379
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Provider Business Mailing Address
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Address Line | 400 S MCCASLIN BLVD STE 103
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City | LOUISVILLE
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State | CO
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Zip | 80027-9701
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Country | US
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Telephone | 303-319-5283
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Fax | 303-666-7379
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | DR0060819
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License Number State | CO
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