MEDICARE: DR. DAVID A IVERSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	32758	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134382518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID A IVERSON M.D.

Provider Business Mailing Address
First Line	:	1155 N SHERMAN ST STE 307
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-2295
Country	:	US
Telephone Number	:	720-916-7297
Fax Number	:	303-630-0682

Provider Business Practice Location Address
First Line	:	1155 N SHERMAN ST STE 309
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-2295
Country	:	US
Telephone Number	:	720-916-7297
Fax Number	:	303-630-0682

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2008
Last Update Date	:	06/22/2024

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