ZANDER, DAVID ALLEN (MD)

Provider Demographics

• NPI: 1730342841
• Name: ZANDER, DAVID ALLEN (MD)
• Entity type: Individual
• First Name: DAVID
• Middle Name: ALLEN
• Last Name: ZANDER
• Gender: M
• Credentials: MD
• Mailing Address - Street 1: 10700 E GEDDES AVE
• Mailing Address - Street 2: SUITE 200
• Mailing Address - City: ENGLEWOOD
• Mailing Address - State: CO
• Mailing Address - Zip Code: 80112-3800
• Mailing Address - Country: US
• Mailing Address - Phone: 303-761-9190
• Mailing Address - Fax: 720-874-4462
• Practice Address - Street 1: 501 E HAMPDEN AVE
• Practice Address - City: ENGLEWOOD
• Practice Address - State: CO
• Practice Address - Zip Code: 80113-2702
• Practice Address - Country: US
• Practice Address - Phone: 303-761-9190
• Practice Address - Fax: 720-874-4462
• Is Sole Proprietor?: No
• Enumeration Date: 2008-07-08
• Last Update Date: 2019-09-16

Provider Licenses

State	License ID	Taxonomies
HI	MD18672	2085R0202X
KS	04-38845	2085R0202X
NE	29140	2085R0202X
MA	254338	2085R0202X
CO	56633	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IA	1730342841	Medicaid
WY	1134402415	Medicaid
WY	1730342841	Medicaid
CO	89770137	Medicaid
OK	200640480A	Medicaid
KS	201133050A	Medicaid
NM	05775736	Medicaid
AZ	154795	Medicaid
WY	1730342841	Medicaid
OK	200640480A	Medicaid
NE	$$$$$$$$$00	Medicaid
NE	$$$$$$$$$06	Medicaid
NE	$$$$$$$$$08	Medicaid
IA	1730342841	Medicaid
NE	$$$$$$$$$07	Medicaid
NM	05775736	Medicaid
WY	1134402415	Medicaid
NM	05775736	Medicaid
HI	H108226	Medicare PIN
CO	486908YQPG	Medicare PIN
WY	1730342841	Medicaid
HI	H108224	Medicare PIN
NE	$$$$$$$$$03	Medicaid
WY	1134402415	Medicaid
CO	486908ZLJ3	Medicare PIN
CO	486908YQ33	Medicare PIN
NE	$$$$$$$$$00	Medicaid
KS	KA3249077	Medicare PIN
KS	111257086	Medicare PIN