Basic Information
| Provider Information | |||||||||
| NPI: | 1053992677 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SWEDISH PORTER EKG INTERPRETATION SERVICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3464 S. WILLOW STREET | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802314531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037552900 | ||||||||
| FaxNumber: | 3037550404 | ||||||||
| Practice Location | |||||||||
| Address1: | 2525 S. DOWNING ST. | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802105817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037442706 | ||||||||
| FaxNumber: | 3037442570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2021 | ||||||||
| LastUpdateDate: | 04/15/2021 | ||||||||
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| AuthorizedOfficialLastName: | FRANK | ||||||||
| AuthorizedOfficialFirstName: | GEORGE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3039338240 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 04/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.