Provider Demographics
NPI:1992817068
Name:EAST DENVER PULMONARY & CRITICAL CARE ASSOC
Entity type:Organization
Organization Name:EAST DENVER PULMONARY & CRITICAL CARE ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:PLUSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-320-1221
Mailing Address - Street 1:4500 E 9TH AVE STE 540
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3924
Mailing Address - Country:US
Mailing Address - Phone:303-320-1221
Mailing Address - Fax:303-320-0627
Practice Address - Street 1:4500 E 9TH AVE STE 540
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3924
Practice Address - Country:US
Practice Address - Phone:303-320-1221
Practice Address - Fax:303-320-0627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22906174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04004693Medicaid
CO04004693Medicaid