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NPI Code Detail

MEDICARE: DR. DAVID J CONYERS M.D.

MEDICARE: DR. DAVID J CONYERS 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
1174400000XSpecialist26818CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2400000514OTHERCORAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780648378
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J CONYERS M.D.
Provider Business Mailing Address
First Line : 8550 W 38TH AVE
Second Line : SUITE 106
City : WHEAT RIDGE
State : CO
Zip : 80033-4300
Country : US
Telephone Number : 303-421-1440
Fax Number : 303-421-2524
Provider Business Practice Location Address
First Line : 4740 PEARL PKWY STE 200
Second Line :
City : BOULDER
State : CO
Zip : 80301-3080
Country : US
Telephone Number : 303-449-2730
Fax Number : 303-449-5821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 07/21/2022

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