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NPI Code Detail

MEDICARE: CTMD LLC DBA PARKSIDE HEART CARE

MEDICARE: CTMD LLC DBA PARKSIDE HEART CARE
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
1174400000XSpecialist28056CO

General Provider Information

NPI Number : 1902172786
Entity Type Code : Organization
Provider Name (Legal Business Name) : CTMD LLC DBA PARKSIDE HEART CARE
Provider Business Mailing Address
First Line : 1729 ALAMO AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-7307
Country : US
Telephone Number : 719-338-1324
Fax Number :
Provider Business Practice Location Address
First Line : 455 E PIKES PEAK AVE
Second Line : SUITE 100
City : COLORADO SPRINGS
State : CO
Zip : 80903-3672
Country : US
Telephone Number : 719-338-1324
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. CHRISTOPHER NORMAN TULIN
Credential : M.D.
Telephone Number : 719-338-1324
Provider Enumeration Date : 03/27/2012
Last Update Date : 07/17/2013

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Directions to “CTMD LLC DBA PARKSIDE HEART CARE ” Practice Location

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