Healthcare Provider Details

I. General information

NPI: 1700107208
Provider Name (Legal Business Name): EDAN SARID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 03/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 S YOSEMITE ST
CENTENNIAL CO
80112-1406
US

IV. Provider business mailing address

6801 S YOSEMITE ST
CENTENNIAL CO
80112-1406
US

V. Phone/Fax

Practice location:
  • Phone: 303-224-4669
  • Fax:
Mailing address:
  • Phone: 303-773-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6875663
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number54090
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: