Provider Demographics
NPI:1992778724
Name:METRO DENVER ANESTHESIA PC
Entity type:Organization
Organization Name:METRO DENVER ANESTHESIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-407-0521
Mailing Address - Street 1:1900 GRANT ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 GRANT ST
Practice Address - Street 2:SUITE 700
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4301
Practice Address - Country:US
Practice Address - Phone:303-407-0521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCN6469OtherMEDICARE RAILROAD
CO04021440Medicaid
COCN6469OtherMEDICARE RAILROAD