POUDRE VALLEY MEDICAL GROUP LLC NPI 1578242525

NPI Information

  • NPI: 1578242525
  • Provider Name: POUDRE VALLEY MEDICAL GROUP, LLC
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Organization
  • :
  • Address: 2500 ROCKY MOUNTAIN AVE STE 340
    LOVELAND, CO
    ZIP 80538
  • Phone: (970) 829-5535

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NPI Details

POUDRE VALLEY MEDICAL GROUP, LLC is a vascular surgery surgery in Loveland, CO. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. POUDRE VALLEY MEDICAL GROUP, LLC NPI is 1578242525. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

2500 ROCKY MOUNTAIN AVE STE 340
LOVELAND, CO
ZIP 80538-004
Phone: (970) 829-5535
Fax: (970) 221-1000

The provider's authorized official is Jana Conroy .
The authorized official title is Director Of Credentialing and has the following contact phone number (970) 829-5535.

The enumeration date for this NPI number is 7/17/2023 and was last updated on 7/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0000XInternal MedicineCardiovascular DiseaseNo
2208600000XSurgeryNo
32086S0129XSurgeryVascular SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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