| Boulder Family Medicine, Pc | |
|
1000 Alpine Ave Ste 260 Boulder CO 80304-3406 | |
| (303) 996-6923 | |
| (303) 996-6926 |
| Full Name | Boulder Family Medicine, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 Alpine Ave, Boulder, Colorado |
| Authorized Official Name and Position | Charles Tawa (MANAGER/OWNER) |
| Authorized Official Contact | 3039966923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulder Family Medicine, Pc 1000 Alpine Ave Ste 260 Boulder CO 80304-3406 Ph: (303) 996-6923 | Boulder Family Medicine, Pc 1000 Alpine Ave Ste 260 Boulder CO 80304-3406 Ph: (303) 996-6923 |
| NPI Number | 1295929503 |
|---|---|
| Provider Enumeration Date | 08/29/2007 |
| Last Update Date | 11/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295929503 | NPI | - | NPPES |
| C802261 | Other | CO | MEDICARE |
| 01287903 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 28790 (Colorado) | Primary |
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