Healthcare Provider Details

I. General information

NPI: 1982639084
Provider Name (Legal Business Name): WILLIAM ERNEST NIEDERHUT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S CHERRY ST SUITE 1060
DENVER CO
80246-1801
US

IV. Provider business mailing address

650 S CHERRY ST SUITE 1060
DENVER CO
80246-1801
US

V. Phone/Fax

Practice location:
  • Phone: 303-331-0662
  • Fax: 303-377-3849
Mailing address:
  • Phone: 303-331-0662
  • Fax: 303-377-3849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number26406
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: