1205800828 NPI number — BRIAN F ERLING MD

Table of content: BRIAN F ERLING MD (NPI 1205800828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205800828 NPI number — BRIAN F ERLING MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ERLING
Provider First Name:
BRIAN
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205800828
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6200 S SYRACUSE WAY
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
GREENWOOD VILLAGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80111-4737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-401-2386
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2551 W 84TH AVE
Provider Second Line Business Practice Location Address:
ST. ANTHONY NORTH HOSPTIAL, EMERGENCY DEPT.
Provider Business Practice Location Address City Name:
WESTMINSTER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80031-3807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-401-2386
Provider Business Practice Location Address Fax Number:
303-426-2164
Provider Enumeration Date:
02/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  40422 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 43989390 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 128273 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: Z3363 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 60786078 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7717950 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00296491 . This is a "RR MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 200384210A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 122789100 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com