Basic Information
Provider Information
NPI: 1538192612
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUTTER
FirstName: DARREN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10700 E GEDDES AVE
Address2: SUITE 200
City: ENGLEWOOD
State: CO
PostalCode: 801123800
CountryCode: US
TelephoneNumber: 3037619190
FaxNumber: 7208744462
Practice Location
Address1: 10700 E GEDDES AVE
Address2: SUITE 200
City: ENGLEWOOD
State: CO
PostalCode: 801123800
CountryCode: US
TelephoneNumber: 3037619190
FaxNumber: 7208744462
Other Information
ProviderEnumerationDate: 07/09/2006
LastUpdateDate: 04/07/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X29694NEN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X04-39518KSN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XMD18957HIN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X058676GAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X57588COY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
153819261205WY MEDICAID
201146110A05KS MEDICAID
2513507405CO MEDICAID
153819261205IA MEDICAID
153819261205UT MEDICAID
200674850A05OK MEDICAID
22152905AZ MEDICAID
102025305UT MEDICAID
7090606805NM MEDICAID


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