Basic Information
| Provider Information | |||||||||
| NPI: | 1013227651 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COLORADO HEART AND VASCULAR PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11700 W 2ND PLACE | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035952727 | ||||||||
| FaxNumber: | 3035952626 | ||||||||
| Practice Location | |||||||||
| Address1: | 11700 W 2ND PLACE | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802281710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035952727 | ||||||||
| FaxNumber: | 3035952626 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2010 | ||||||||
| LastUpdateDate: | 05/14/2014 | ||||||||
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| AuthorizedOfficialLastName: | PTASNIK | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3035223745 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0001X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | 207RI0011X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207UN0901X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | 207RC0000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.