Healthcare Provider Details

I. General information

NPI: 1457708794
Provider Name (Legal Business Name): DUSTIN J FROEHLICH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 E EGBERT ST STE 200
BRIGHTON CO
80601-2484
US

IV. Provider business mailing address

1870 W 122ND AVE STE 100
WESTMINSTER CO
80234-2075
US

V. Phone/Fax

Practice location:
  • Phone: 303-853-3500
  • Fax: 303-853-3702
Mailing address:
  • Phone: 303-853-3500
  • Fax: 303-853-3702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number57.028757
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0066495
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: