Basic Information
| Provider Information | |||||||||
| NPI: | 1992849541 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALGER | ||||||||
| FirstName: | BRADLEY | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 MARION STREET | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038306666 | ||||||||
| FaxNumber: | 3038307099 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 MARION STREET | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038306666 | ||||||||
| FaxNumber: | 3038307099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2007 | ||||||||
| LastUpdateDate: | 11/14/2013 | ||||||||
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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 | 207Q00000X | 35203 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 080187361 | 01 | CO | MEDICARE ID TYPE UNS | OTHER | 01352038 | 05 | CO | MEDICAID |