MEDICARE: KATHRYN BAIER CHEREFKO DO

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	207P00000X	Emergency Medicine Physician	25MB10078000	NJ
2	207P00000X	Emergency Medicine Physician	DR.0067751	CO

General Provider Information

NPI Number	:	1780022426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN BAIER CHEREFKO DO

Provider Business Mailing Address
First Line	:	PO BOX 110429
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80042-0429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12505 E. 16TH AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-0000
Country	:	US
Telephone Number	:	720-848-6777
Fax Number	:

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

Provider Enumeration Date	:	06/04/2013
Last Update Date	:	05/02/2022

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