Healthcare Provider Details

I. General information

NPI: 1093999138
Provider Name (Legal Business Name): RONALD EDELMAN, D.P.M., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 12/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1563 GILPIN ST
DENVER CO
80218-1630
US

IV. Provider business mailing address

1563 GILPIN ST
DENVER CO
80218-1630
US

V. Phone/Fax

Practice location:
  • Phone: 303-388-0976
  • Fax: 303-388-0978
Mailing address:
  • Phone: 303-388-0976
  • Fax: 303-388-0978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number332
License Number StateCO

VIII. Authorized Official

Name: DR. RONALD EDELMAN
Title or Position: PRESIDENT
Credential: DPM
Phone: 303-388-0976