Basic Information
| Provider Information | |||||||||
| NPI: | 1679754717 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DAVID SOLSBERG, MD., PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 HUNTWICK LN | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801137111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038883396 | ||||||||
| FaxNumber: | 3037621131 | ||||||||
| Practice Location | |||||||||
| Address1: | 3601 S PEARL ST | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801133805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037620060 | ||||||||
| FaxNumber: | 3037621131 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2007 | ||||||||
| LastUpdateDate: | 11/03/2014 | ||||||||
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| AuthorizedOfficialLastName: | SOLSBERG | ||||||||
| AuthorizedOfficialFirstName: | MURRAY | ||||||||
| AuthorizedOfficialMiddleName: | DAVID | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 3038883396 | ||||||||
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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 | 2085N0700X | 33833 | CO | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | 33833 | CO | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | BS3763364 | 01 | DEA | OTHER | C810848 | 01 | CO | MEDICARE PTAN | OTHER | 33833 | 01 | CO | COLORADO STATE LICENSE | OTHER |