MEDICARE: DR. NEIEL D BARONBERG 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	174400000X	Specialist	17261	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28606	OTHER	CO	BLUE CROSS
2	840826594001	OTHER	CO	ROCKY MTN HEALTH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	920523	OTHER	CO	PACIFICARE/EYE SPECIALIST

General Provider Information

NPI Number	:	1679510077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIEL D BARONBERG M.D.

Provider Business Mailing Address
First Line	:	2480 S DOWNING ST
Second Line	:	SUITE 100
City	:	DENVER
State	:	CO
Zip	:	80210-5890
Country	:	US
Telephone Number	:	303-777-5455
Fax Number	:	303-777-1175

Provider Business Practice Location Address
First Line	:	2480 S DOWNING ST
Second Line	:	SUITE 100
City	:	DENVER
State	:	CO
Zip	:	80210-5890
Country	:	US
Telephone Number	:	303-777-5455
Fax Number	:	303-777-1175

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	09/23/2013

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