Organization · Type 2 NPI

Intermountain Medical Group Denver, LLC

Neurology Physician · Denver, CO

NPI number 1104574409 Active

Practice location

130 Rampart Way Ste 150
Denver, CO 80230-6442

Call (303) 812-6930 Map

Fax (303) 318-2477

Mailing address

500 Eldorado Blvd Ste 4300
Broomfield, CO 80021-3564

Specialties and licenses

Taxonomy	Code	License
Neuro-ophthalmology Physician	207WX0109X	None listed
Neurology Physician Primary	2084N0400X	None listed

Neurology Physician: A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

3 other providers at this address

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NPI record

NPI: 1104574409
Entity type: Organization (Type 2)
Issued: Mar 15, 2022
Last updated: Jun 28, 2024
Status: Active
Subpart: Yes of Intermountain Front Range, Inc.

Other names

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Rampart Clinic Neurology & Neuro-Ophthamology · doing business as

Authorized official

Jon McDaniel
VP Finance
(303) 272-0231

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104574409

Intermountain Medical Group Denver, LLC's National Provider Identifier is 1104574409, issued on Mar 15, 2022. The primary taxonomy on file is Neurology Physician (2084N0400X), and the practice location is in Denver, CO. The record was last updated on Jun 28, 2024.