Healthcare Provider Details

I. General information

NPI: 1912522715
Provider Name (Legal Business Name): ADAM MAYO BARTHOLOMEO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 08/14/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13123 E 16TH AVE # 518
AURORA CO
80045-7106
US

IV. Provider business mailing address

13123 E 16TH AVE # 518
AURORA CO
80045-7106
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-1048
  • Fax: 720-777-7247
Mailing address:
  • Phone: 720-777-1048
  • Fax: 720-777-7247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL84219
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: