| Boulder Endocrinology Pllc | |
|
892 W South Boulder Rd Louisville CO 80027-2453 | |
| (303) 586-5200 | |
| (303) 586-5201 |
| Full Name | Boulder Endocrinology Pllc |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 892 W South Boulder Rd, Louisville, Colorado |
| Authorized Official Name and Position | Kelly A. Mandagere (M.D.) |
| Authorized Official Contact | 3035865200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulder Endocrinology Pllc 892 W South Boulder Rd Louisville CO 80027-2453 Ph: (303) 586-5200 | Boulder Endocrinology Pllc 892 W South Boulder Rd Louisville CO 80027-2453 Ph: (303) 586-5200 |
| NPI Number | 1588817464 |
|---|---|
| Provider Enumeration Date | 10/23/2008 |
| Last Update Date | 07/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588817464 | NPI | - | NPPES |
| 81287895 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 45001 (Colorado) | Primary |
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