MEDICARE: MEDICAL CENTER CORP

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
1	261QP2300X	Primary Care Clinic/Center
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1083273049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CENTER CORP

Provider Business Mailing Address
First Line	:	1780 S BELLAIRE ST STE 402
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4323
Country	:	US
Telephone Number	:	303-946-3322
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 E EVANS AVE STE 101
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-5320
Country	:	US
Telephone Number	:	303-946-3322
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. SARA VATAN
Credential	:	MD
Telephone Number	:	303-946-3322

Provider Enumeration Date	:	06/12/2019
Last Update Date	:	06/12/2019

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Directions to “MEDICAL CENTER CORP ” Practice Location

Language	Start Address	Practice Location

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