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General NPI Number Information
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NPI Number | 1710327358
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Entity Type | Individual
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Provider Name | BRIAN CERVENKA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 1635 AURORA CT
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City | AURORA
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State | CO
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Zip | 80045-2541
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Country | US
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Telephone | 720-848-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 12605 E 16TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2545
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Country | US
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Telephone | 303-493-7000
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Fax |
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 57130
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 35.136074
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | DR0067707
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | DR0067707
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License Number State | CO
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