1982651329 NPI number — CLAUDIA M VAN DIJK M.D.

Table of content: CLAUDIA M VAN DIJK M.D. (NPI 1982651329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982651329 NPI number — CLAUDIA M VAN DIJK M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VAN DIJK
Provider First Name:
CLAUDIA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982651329
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4891 INDEPENDENCE ST
Provider Second Line Business Mailing Address:
SUITE 120
Provider Business Mailing Address City Name:
WHEAT RIDGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80033-6752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-456-5495
Provider Business Mailing Address Fax Number:
303-456-7490

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5265 VANCE ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
ARVADA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80002-3714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-232-3366
Provider Business Practice Location Address Fax Number:
303-232-8734
Provider Enumeration Date:
05/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  42208 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: 42208 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00330486 . This is a "RR MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com