MEDICARE: DR. EDMUND CASPER 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	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	16856	CO

General Provider Information

NPI Number	:	1740248319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDMUND CASPER M.D.

Provider Business Mailing Address
First Line	:	1879 S XENIA CT
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-3331
Country	:	US
Telephone Number	:	303-755-4271
Fax Number	:	303-337-2897

Provider Business Practice Location Address
First Line	:	3400 E BAYAUD AVE
Second Line	:	210
City	:	DENVER
State	:	CO
Zip	:	80209-2926
Country	:	US
Telephone Number	:	303-880-3545
Fax Number	:

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	07/21/2022

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