Organization · Type 2 NPI

Intermountain Medical Group Denver, LLC

Gynecologic Oncology Physician · Lafayette, CO

NPI number 1467282822 Active

Practice location

300 Exempla Cir Ste 470
Lafayette, CO 80026-3396

Call (303) 403-6330 Map

Fax (303) 272-0280

Mailing address

500 Eldorado Blvd Ste 4300
Broomfield, CO 80021-3564

Specialties and licenses

Taxonomy	Code	License
Gynecologic Oncology Physician Primary	207VX0201X	None listed

Gynecologic Oncology Physician: An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.

6 other providers at this address

NPI record

NPI: 1467282822
Entity type: Organization (Type 2)
Issued: Aug 1, 2024
Last updated: Aug 1, 2024
Status: Active
Subpart: Yes of Intermountain Front Range, Inc.

Other names

Lafayette Clinic - Gynological Oncology · doing business as

Authorized official

Jon McDaniel
VP Fianance
(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 1467282822

Intermountain Medical Group Denver, LLC's National Provider Identifier is 1467282822, issued on Aug 1, 2024. The primary taxonomy on file is Gynecologic Oncology Physician (207VX0201X), and the practice location is in Lafayette, CO. The record was last updated on Aug 1, 2024.