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General NPI Number Information
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NPI Number | 1447466073
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Entity Type | Organization
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Legal Business Name | MAYFAIR INTERNAL MEDICINE, P.C.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 6311 E 14TH AVE
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City | DENVER
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State | CO
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Zip | 80220-2821
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Country | US
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Telephone | 303-333-6434
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Fax | 303-333-6505
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Provider Business Mailing Address
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Address Line | 6311 E 14TH AVE
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City | DENVER
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State | CO
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Zip | 80220-2821
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Country | US
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Telephone | 303-333-6434
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Fax | 303-333-6505
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Authorized Official
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Title or Position | PHYSICIAN PARTNER
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Name | MS. EDITH SARAH LOVEGREN
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Credential | MD
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Telephone | 303-333-6434
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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 |
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License Number State |
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