Provider Demographics
NPI:1588932008
Name:GOTTESFELD, RAY LEE (MD)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:LEE
Last Name:GOTTESFELD
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 1:235 IVY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-5865
Mailing Address - Country:US
Mailing Address - Phone:303-322-0422
Mailing Address - Fax:
Practice Address - Street 1:235 IVY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-5865
Practice Address - Country:US
Practice Address - Phone:303-322-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23610207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology