Organization · Type 2 NPI

Magnolia Medical Group

Addiction Medicine (Internal Medicine) Physician · Denver, CO

NPI number 1003672619 Active

Practice location

1490 N Lafayette St Ste 104
Denver, CO 80218-2391

Mailing address

PO Box 29605, Dept # 800927
Phoenix, AZ 85038-9605

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Addiction Medicine (Internal Medicine) Physician Primary 207RA0401XNone listed

Addiction Medicine (Internal Medicine) Physician: An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

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About NPI 1003672619

Magnolia Medical Group's National Provider Identifier is 1003672619, issued on Feb 22, 2024. The primary taxonomy on file is Addiction Medicine (Internal Medicine) Physician (207RA0401X), and the practice location is in Denver, CO. The record was last updated on Feb 17, 2026.