MEDICARE: CREEKSIDE ENDOCRINE ASSOCIATES, 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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	27647	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DD3981	OTHER	CO	RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1124024799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREEKSIDE ENDOCRINE ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	4101 E. LOUISIANA AVE
Second Line	:	STE 200
City	:	DENVER
State	:	CO
Zip	:	80246-3431
Country	:	US
Telephone Number	:	303-388-6410
Fax Number	:	303-388-1069

Provider Business Practice Location Address
First Line	:	4101 E. LOUISIANA AVE
Second Line	:	STE 200
City	:	DENVER
State	:	CO
Zip	:	80246-3431
Country	:	US
Telephone Number	:	303-388-6410
Fax Number	:	303-388-1069

Authorized Official
Title or Position	:	OWNER - PHYSICIAN
Name	:	LEONARD R. ZEMEL
Credential	:	M.D.
Telephone Number	:	303-388-6410

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	02/18/2022

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