=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619327707
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PETER I MONHEIT, M.D., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2016
-----------------------------------------------------
Last Update Date | 06/20/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3545 S TAMARAC DR SUITE 130
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80237-1418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-771-1647
-----------------------------------------------------
Fax | 303-771-1659
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3545 S TAMARAC DR SUITE 130
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80237-1418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-771-1647
-----------------------------------------------------
Fax | 303-771-1659
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANGER
-----------------------------------------------------
Name | MS. HEDY MONHEIT
-----------------------------------------------------
Credential | OFFICE MANAGER
-----------------------------------------------------
Telephone | 303-771-1647
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number | 0009921100
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------