Healthcare Provider Details

I. General information

NPI: 1902940711
Provider Name (Legal Business Name): RICHARD E ALBIM MD PH DDC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVENUE SUITE 4350
DENVER CO
80218-1253
US

IV. Provider business mailing address

1601 E 19TH AVENUE SUITE 4350
DENVER CO
80218-1253
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-9000
  • Fax: 303-832-3748
Mailing address:
  • Phone: 303-839-9000
  • Fax: 303-832-3748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number21643
License Number StateCO

VIII. Authorized Official

Name: DR. RICHARD ELLIS ALBIN
Title or Position: PRESIDENT
Credential: MD PHD
Phone: 303-839-9000