Provider Demographics
NPI:1366541294
Name:FALCHOOK, GERALD STEVEN (MD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:STEVEN
Last Name:FALCHOOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:720-754-2610
Mailing Address - Fax:720-754-2659
Practice Address - Street 1:1800 WILLIAMS ST
Practice Address - Street 2:#300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1234
Practice Address - Country:US
Practice Address - Phone:720-754-2610
Practice Address - Fax:720-754-2659
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9191207R00000X
CO42949207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175522501Medicaid
TX145221104Medicaid
CO66326524Medicaid
CO66326524Medicaid
TX175522501Medicaid
TX145221104Medicaid
CO360243YWUPMedicare PIN
COP01557035Medicare PIN