Provider Demographics
NPI:1831233543
Name:BRETH, GEORGE F (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:F
Last Name:BRETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5437
Mailing Address - Country:US
Mailing Address - Phone:303-764-4480
Mailing Address - Fax:303-764-4485
Practice Address - Street 1:2045 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5437
Practice Address - Country:US
Practice Address - Phone:303-764-4480
Practice Address - Fax:303-764-4485
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29007207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01290071Medicaid
004778OtherKAISER-COMMERCIAL NUMBER
COA85141Medicare UPIN
CO01290071Medicaid
004778OtherKAISER-COMMERCIAL NUMBER