Basic Information
| Provider Information | |||||||||
| NPI: | 1922042373 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOLSTAD | ||||||||
| FirstName: | KAARE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3455 LUTHERAN PKWY STE 105 | ||||||||
| Address2: | |||||||||
| City: | WHEAT RIDGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800336028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036652603 | ||||||||
| FaxNumber: | 3036652605 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 W 144TH AVE STE 230 | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800239328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036652603 | ||||||||
| FaxNumber: | 3036652605 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X | K6057 | TX | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207XX0005X | 53701 | CO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00247085 | 01 | TX | RAILROAD MEDICARE | OTHER | 8S9716 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER |