Provider Demographics
NPI:1063962645
Name:COLORADO CENTER OF MEDICAL EXCELLENCE
Entity type:Organization
Organization Name:COLORADO CENTER OF MEDICAL EXCELLENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:MARION
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-320-2061
Mailing Address - Street 1:4700 HALE PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4045
Mailing Address - Country:US
Mailing Address - Phone:720-320-2061
Mailing Address - Fax:
Practice Address - Street 1:4700 HALE PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-4045
Practice Address - Country:US
Practice Address - Phone:720-320-2061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty