Provider Demographics
NPI:1992817274
Name:STEVEN F PODGORSKI MD PC
Entity type:Organization
Organization Name:STEVEN F PODGORSKI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:PODGORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-761-9944
Mailing Address - Street 1:601 E HAMPDEN
Mailing Address - Street 2:SUITE 490
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2799
Mailing Address - Country:US
Mailing Address - Phone:303-761-9944
Mailing Address - Fax:303-788-6995
Practice Address - Street 1:601 E HAMPDEN
Practice Address - Street 2:SUITE 490
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2799
Practice Address - Country:US
Practice Address - Phone:303-761-9944
Practice Address - Fax:303-788-6995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25807207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01258078Medicaid
CO01258078Medicaid
D24701Medicare UPIN