Provider Demographics
NPI:1801112354
Name:SMOLKIN, MAXIMILIANO JAVIER (MD)
Entity type:Individual
Prefix:DR
First Name:MAXIMILIANO
Middle Name:JAVIER
Last Name:SMOLKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2525 S DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-0429
Mailing Address - Country:US
Mailing Address - Phone:303-715-7184
Mailing Address - Fax:720-874-5886
Practice Address - Street 1:2525 S DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-0429
Practice Address - Country:US
Practice Address - Phone:303-715-7184
Practice Address - Fax:720-874-5886
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0052702207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program