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NPI Code Detail

MEDICARE: BENJAMIN J KEIDAN MD

MEDICARE: BENJAMIN J KEIDAN MD
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
1207R00000XInternal Medicine PhysicianDR.0043558CO

General Provider Information

NPI Number : 1316032584
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN J KEIDAN MD
Provider Business Mailing Address
First Line : 5450 WESTERN AVE
Second Line :
City : BOULDER
State : CO
Zip : 80301-2709
Country : US
Telephone Number : 303-415-4250
Fax Number : 303-440-9629
Provider Business Practice Location Address
First Line : 5495 ARAPAHOE AVE STE 100
Second Line :
City : BOULDER
State : CO
Zip : 80303-1224
Country : US
Telephone Number : 303-415-4250
Fax Number : 303-440-9629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 05/10/2019

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