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Contact Information

BRIAN P GRADISEK, DPM
1400 28TH ST STE 2
BOULDER, CO80303-1096
 Phone: 303-449-2000
 Fax: 303-449-9475
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BRIAN P GRADISEK · (Male)

NPI Number 1700178092
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 05/05/2011
Last updated 07/27/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • CO License # 0000766
  • IL License # 016005597
  • IL Medicaid 016005597
Hospital affiliation(s)
  • BOULDER COMMUNITY HOSPITAL - (Acute Care)
    4747 ARAPAHOE AVENUE
    BOULDER, CO 80304
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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