Basic Information
| Provider Information | |||||||||
| NPI: | 1942589213 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLEMBESKI | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1960 N OGDEN ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802183666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033181540 | ||||||||
| FaxNumber: | 3033182481 | ||||||||
| Practice Location | |||||||||
| Address1: | 4545 E 9TH AVE STE 460 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802203904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033882922 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2011 | ||||||||
| LastUpdateDate: | 01/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TL-4069 | CO | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208600000X | DR.0056891 | CO | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.