Provider Demographics
NPI:1902063852
Name:DANNEMILLER, ELISA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ELISA
Middle Name:MARIE
Last Name:DANNEMILLER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 CHERRY CREEK SOUTH DR
Mailing Address - Street 2:#925
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2703
Mailing Address - Country:US
Mailing Address - Phone:703-201-2295
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:DENVER HEALTH, EMERGENCY MEDICINE
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-7142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE33055207P00000X
MDD0102370207P00000X
CO2733207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60471387Medicaid
CO022183OtherKAISER COMMERCIAL NUMBER