Healthcare Provider Details

I. General information

NPI: 1871711036
Provider Name (Legal Business Name): AARON M EBERHARDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 W 38TH AVE
DENVER CO
80033-6005
US

IV. Provider business mailing address

DEPT 1265
DENVER CO
80256-0001
US

V. Phone/Fax

Practice location:
  • Phone: 303-425-4500
  • Fax:
Mailing address:
  • Phone: 866-898-7136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTL-1333
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number46265
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: