Healthcare Provider Details

I. General information

NPI: 1649354549
Provider Name (Legal Business Name): DAVID A HARTEMINK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7850 VANCE DR #225
ARVADA CO
80003-2118
US

IV. Provider business mailing address

7850 VANCE DR #225
ARVADA CO
80003-2118
US

V. Phone/Fax

Practice location:
  • Phone: 303-431-8881
  • Fax: 303-431-8564
Mailing address:
  • Phone: 303-431-8881
  • Fax: 303-431-8564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number48981
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: