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NPI Code Detail

MEDICARE: EAST WEST FAMILY HEALTH LLC

MEDICARE: EAST WEST FAMILY HEALTH LLC
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
1207R00000XInternal Medicine Physician
2207Q00000XFamily Medicine Physician35559CO

General Provider Information

NPI Number : 1417402918
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST WEST FAMILY HEALTH LLC
Provider Business Mailing Address
First Line : 8200 E. BELLEVIEW AVENUE
Second Line : SUITE 203-C
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-2835
Country : US
Telephone Number : 303-221-6797
Fax Number : 303-221-4563
Provider Business Practice Location Address
First Line : 8200 E. BELLEVIEW AVENUE
Second Line : SUITE 203-C
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-2835
Country : US
Telephone Number : 303-221-6797
Fax Number : 303-221-4563
Authorized Official
Title or Position : OWNER/PHYSICIAN
Name : MR. FLOYD B RUSSAK
Credential : M.D.
Telephone Number : 303-591-8161
Provider Enumeration Date : 08/25/2016
Last Update Date : 05/29/2019

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Directions to “EAST WEST FAMILY HEALTH LLC ” Practice Location

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