Healthcare Provider Details

I. General information

NPI: 1790085892
Provider Name (Legal Business Name): HARVARD AVENUE INTERNAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2010
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 E HARVARD AVE SUITE 455
DENVER CO
80210-5073
US

IV. Provider business mailing address

850 E HARVARD AVE SUITE 455
DENVER CO
80210-5073
US

V. Phone/Fax

Practice location:
  • Phone: 303-722-2724
  • Fax: 303-722-3121
Mailing address:
  • Phone: 303-722-2724
  • Fax: 303-722-3121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWARD JAMES HO
Title or Position: OWNER
Credential: M.D.
Phone: 303-722-2724