MEDICARE: DR. RENATTA J OSTERDOCK 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	207T00000X	Neurological Surgery Physician	46246	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	:	1982630588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENATTA J OSTERDOCK M.D.

Provider Business Mailing Address
First Line	:	1601 E 19TH AVE
Second Line	:	SUITE 4600
City	:	DENVER
State	:	CO
Zip	:	80218-1289
Country	:	US
Telephone Number	:	303-832-2449
Fax Number	:	303-832-3832

Provider Business Practice Location Address
First Line	:	1601 E 19TH AVE STE 4600
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1289
Country	:	US
Telephone Number	:	303-832-2449
Fax Number	:	303-832-3832

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

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	07/10/2017

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