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POUDRE VALLEY MEDICAL GROUP LLC NPI 1689445702


NPI Information

NPI: 1689445702
Provider Name: POUDRE VALLEY MEDICAL GROUP, LLC

Doing Business As: UCHEALTH MEDICAL GROUP

Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
2750 BROADWAY ST STE 2178
BOULDER, CO
ZIP 80304
Phone: (970) 624-1800
Get Directions

POUDRE VALLEY MEDICAL GROUP, LLC is a vascular surgery surgery in Boulder, 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 1689445702. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Uchealth Medical Group.

The provider's business location address is:

2750 BROADWAY ST STE 2178
BOULDER, CO
ZIP 80304-573
Phone: (970) 624-1800

The provider's authorized official is Jana Conroy .
The authorized official title is Director Of Credentialing and has the following contact phone number (970) 624-1800.

The enumeration date for this NPI number is 1/9/2024 and was last updated on 1/23/2024.


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
22086S0129XSurgeryVascular SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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