MEDICARE: DR. SCOT M SEDLACEK MD

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	207RH0003X	Hematology & Oncology Physician	25511	CO

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	:	1215911540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOT M SEDLACEK MD

Provider Business Mailing Address
First Line	:	7951 E MAPLEWOOD AVE
Second Line	:	STE 300
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111
Country	:	US
Telephone Number	:	303-930-7800
Fax Number	:	303-930-7860

Provider Business Practice Location Address
First Line	:	4700 E. HALE PARKWAY
Second Line	:	STE 400
City	:	DENVER
State	:	CO
Zip	:	80220
Country	:	US
Telephone Number	:	303-321-0302
Fax Number	:	303-321-9296

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	11/03/2008

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