MEDICARE: PLATTE VALLEY EMERGENCY PHYSICIANS, 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	207P00000X	Emergency Medicine Physician

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	:	1508836198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLATTE VALLEY EMERGENCY PHYSICIANS, PC

Provider Business Mailing Address
First Line	:	1241 W MINERAL AVE
Second Line	:	SUITE 100
City	:	LITTLETON
State	:	CO
Zip	:	80120-5685
Country	:	US
Telephone Number	:	303-759-0854
Fax Number	:	303-759-0864

Provider Business Practice Location Address
First Line	:	1600 PRAIRIE CENTER PKWY
Second Line	:
City	:	BRIGHTON
State	:	CO
Zip	:	80601-4006
Country	:	US
Telephone Number	:	303-659-1531
Fax Number	:	303-654-8170

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. TERESA A. LONG
Credential	:
Telephone Number	:	303-759-0854

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	05/14/2008

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