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General NPI Number Information
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NPI Number | 1598724445
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Entity Type | Individual
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Provider Name | OVIDIO BERNABE BERMUDEZ MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 8140 E 5TH AVENUE EATING RECOVERY CENTER
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City | DENVER
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State | CO
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Zip | 80230-6492
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Country | US
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Telephone | 918-671-7393
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Fax | 303-364-1812
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Provider Business Mailing Address
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Address Line | 8140 E 5TH AVENUE EATING RECOVERY CENTER
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City | DENVER
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State | CO
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Zip | 80230-6492
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Country | US
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Telephone | 918-671-7393
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Fax | 303-364-1812
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 49298
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License Number State | CO
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