Provider Demographics
NPI:1194145656
Name:MILE HIGH WOUND AND HYPERBARIC MEDICINE PLLC
Entity type:Organization
Organization Name:MILE HIGH WOUND AND HYPERBARIC MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NELU
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:COJANU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-202-7433
Mailing Address - Street 1:12065 W AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4765
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12065 W AUBURN DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-4765
Practice Address - Country:US
Practice Address - Phone:706-202-7433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0051390207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0051390OtherLICENSURE - STATE OF COLORADO