Provider Demographics
NPI:1962763938
Name:MILGROM, BENJAMIN K (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:K
Last Name:MILGROM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5600 S QUEBEC
Mailing Address - Street 2:STE 312A
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2208
Mailing Address - Country:US
Mailing Address - Phone:720-754-2296
Mailing Address - Fax:844-669-1725
Practice Address - Street 1:1719 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1235
Practice Address - Country:US
Practice Address - Phone:720-754-2296
Practice Address - Fax:446-669-1725
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273490207R00000X
CO67439208M00000X
CODR.0067439207Q00000X, 207R00000X
CAA149803207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine