Provider Demographics
NPI:1528059789
Name:PARDOS, GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:PARDOS
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 1:55 MADISON ST
Mailing Address - Street 2:SUITE 355
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5419
Mailing Address - Country:US
Mailing Address - Phone:303-398-7320
Mailing Address - Fax:
Practice Address - Street 1:55 MADISON ST
Practice Address - Street 2:SUITE 355
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5419
Practice Address - Country:US
Practice Address - Phone:303-377-2020
Practice Address - Fax:303-377-2022
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24332174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD24433Medicare UPIN
COD3938Medicare ID - Type Unspecified