Basic Information
| Provider Information | |||||||||
| NPI: | 1245545003 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDENHERSH | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8000 E MAPLEWOOD AVE | ||||||||
| Address2: | BUILDING 5, SUITE 200 | ||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801114766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037854700 | ||||||||
| FaxNumber: | 7204399500 | ||||||||
| Practice Location | |||||||||
| Address1: | 8000 E MAPLEWOOD AVE | ||||||||
| Address2: | BUILDING 5, SUITE 200 | ||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801114766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037854700 | ||||||||
| FaxNumber: | 7204399500 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2010 | ||||||||
| LastUpdateDate: | 12/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 57164 | CO | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 017761900 | 05 | FL | MEDICAID | 44705042 | 05 | CO | MEDICAID |