Healthcare Provider Details

I. General information

NPI: 1356306294
Provider Name (Legal Business Name): MITCHELL ALEX FREMLING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12207 PECOS ST STE 300
WESTMINSTER CO
80234-3892
US

IV. Provider business mailing address

12207 PECOS ST STE 300
WESTMINSTER CO
80234-3892
US

V. Phone/Fax

Practice location:
  • Phone: 303-466-3261
  • Fax: 303-466-3674
Mailing address:
  • Phone: 303-466-3261
  • Fax: 303-466-3674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number36316
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number36316
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: