Medical Rtd INC
NPI #1912030743 in Wheat Ridge, Colorado
Provider Information
- NPI Number
- 1912030743
- Entity Type
- Organization
- Organization Name
- Medical Rtd INC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Mar 13, 2007
- Last Updated
- Mar 7, 2023
Practice Location
- Address
- 7615 W 38TH AVE
- Address 2
- UNIT B-123
- City
- Wheat Ridge
- State
- Colorado
- ZIP Code
- 80033-6172
- Phone
- (303) 432-2776
Authorized Official
- Name
- TATYANA I DATKHAEVA, MD
- Title
- OWNER PHYSICIAN
- Phone
- (720) 540-7155
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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