MEDICARE: INTERNAL MEDICINE ASSOCIATES, P.C.

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	207R00000X	Internal Medicine Physician	45091	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45091	OTHER	CO	LICENSE

General Provider Information

NPI Number	:	1770736035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNAL MEDICINE ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	4950 S YOSEMITE ST
Second Line	:	SUITE F2 - 304
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-1349
Country	:	US
Telephone Number	:	303-999-6382
Fax Number	:

Provider Business Practice Location Address
First Line	:	4950 S YOSEMITE ST
Second Line	:	SUITE F2 - 304
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-1349
Country	:	US
Telephone Number	:	303-999-6382
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SERGIU SURDULESCU
Credential	:	M.D.
Telephone Number	:	303-999-6382

Provider Enumeration Date	:	10/30/2008
Last Update Date	:	12/31/2008

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