Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 31645 | CO |
NPI | 1396871265 |
---|---|
Provider Name | Dr. Michael R Menachof |
First Address | Greenwood Village, CO 80111-3656 |
Second Address | Greenwood Village, CO 80111-3656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 06/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01316454 | (05) | CO |
1396871265 | NPI (01) | CO |
1710065446 | NPI (01) | CO |
48138274 | (05) | CO |
E78603 | (02) | CO |