MEDICARE: ANTHONY E MADRID M.D.

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	207RG0100X	Gastroenterology Physician	41706	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00165338	OTHER	CO	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1134154313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY E MADRID M.D.

Provider Business Mailing Address
First Line	:	3333 S WADSWORTH BLVD UNIT D100
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-5117
Country	:	US
Telephone Number	:	303-205-1090
Fax Number	:	303-205-1120

Provider Business Practice Location Address
First Line	:	1300 S POTOMAC ST STE 104
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80012-4526
Country	:	US
Telephone Number	:	303-673-5553
Fax Number	:	303-671-2790

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	06/13/2013

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Directions to “ ANTHONY E MADRID M.D.” Practice Location

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