Healthcare Provider Details

I. General information

NPI: 1619506318
Provider Name (Legal Business Name): MARY ABKEMEIER TUHOLSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY ELIZABETH ABKEMEIER

II. Dates (important events)

Enumeration Date: 04/04/2020
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 E 17TH AVE
AURORA CO
80045-2548
US

IV. Provider business mailing address

2068 TRENTON ST
DENVER CO
80238-3200
US

V. Phone/Fax

Practice location:
  • Phone: 208-480-0000
  • Fax:
Mailing address:
  • Phone: 678-910-7835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberDR.0077126
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number125.07793
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2026-03263
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: