Provider Demographics
NPI:1063191849
Name:KUCHEM, CASEY MICHAEL (PA-C)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:MICHAEL
Last Name:KUCHEM
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2055 N HIGH ST STE 370
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5545
Mailing Address - Country:US
Mailing Address - Phone:303-839-6001
Mailing Address - Fax:
Practice Address - Street 1:2055 N HIGH ST STE 370
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5545
Practice Address - Country:US
Practice Address - Phone:303-839-6001
Practice Address - Fax:303-839-6033
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2024-02-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant