Healthcare Provider Details

I. General information

NPI: 1437111010
Provider Name (Legal Business Name): MICHAEL AMENT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 DETROIT ST
DENVER CO
80206-4833
US

IV. Provider business mailing address

PO BOX 6996
DENVER CO
80206-0996
US

V. Phone/Fax

Practice location:
  • Phone: 303-834-5677
  • Fax: 303-835-0730
Mailing address:
  • Phone: 303-834-5677
  • Fax: 303-835-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number40730
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: