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NPI Code Detail

MEDICARE: WHEAT RIDGE FAMILY CLINIC PC

MEDICARE: WHEAT RIDGE FAMILY CLINIC PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center27027CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013070051
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHEAT RIDGE FAMILY CLINIC PC
Provider Business Mailing Address
First Line : 6301 W 38TH AVE
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-5057
Country : US
Telephone Number : 303-940-9118
Fax Number : 303-940-5943
Provider Business Practice Location Address
First Line : 6301 W 38TH AVE
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-5057
Country : US
Telephone Number : 303-940-9118
Fax Number : 303-940-5943
Authorized Official
Title or Position : OWNER PRESIDENT
Name : DR. MAURICE A ARCHULETA
Credential : MD
Telephone Number : 303-940-9118
Provider Enumeration Date : 12/19/2006
Last Update Date : 03/18/2011

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Directions to “WHEAT RIDGE FAMILY CLINIC PC ” Practice Location

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