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General NPI Number Information
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NPI Number | 1962465450
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR INTERNAL MEDICINEPC
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 3955 E EXPOSITION AVE SUITE 104
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City | DENVER
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State | CO
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Zip | 80209-5000
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Country | US
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Telephone | 303-454-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 3955 E EXPOSITION AVE STE 104
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City | DENVER
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State | CO
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Zip | 80209-5031
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Country | US
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Telephone | 303-454-2266
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEVIN LUTZ
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Credential | MD
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Telephone | 303-454-2266
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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 | 32791
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License Number State | CO
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