MEDICARE: BRONWEN J MAGRAW 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
1	207R00000X	Internal Medicine Physician	DR22484	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CE2404	OTHER	CO	OLD MEDICARE PIN

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	:	1851380323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRONWEN J MAGRAW M.D.

Provider Business Mailing Address
First Line	:	PO BOX 62
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81502-0062
Country	:	US
Telephone Number	:	970-244-7460
Fax Number	:	970-244-7487

Provider Business Practice Location Address
First Line	:	425 PATTERSON RD
Second Line	:	SUITE 401
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81506-1953
Country	:	US
Telephone Number	:	970-298-7461
Fax Number	:	970-298-2192

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	02/15/2011

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Directions to “ BRONWEN J MAGRAW M.D.” Practice Location

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