Healthcare Provider Details

I. General information

NPI: 1104851351
Provider Name (Legal Business Name): EDWARD B ARENSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 E HAMPDEN AVE STE 450
ENGLEWOOD CO
80113-3878
US

IV. Provider business mailing address

1610 LITTLE RAVEN ST UNIT 410
DENVER CO
80202-6178
US

V. Phone/Fax

Practice location:
  • Phone: 720-389-7749
  • Fax: 720-519-0229
Mailing address:
  • Phone: 720-389-7749
  • Fax: 720-389-7749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number18299
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: