Provider Demographics
NPI:1871711036
Name:EBERHARDT, AARON M (MD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:M
Last Name:EBERHARDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT 1265
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80256-0001
Mailing Address - Country:US
Mailing Address - Phone:866-898-7136
Mailing Address - Fax:
Practice Address - Street 1:8300 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80033-6005
Practice Address - Country:US
Practice Address - Phone:303-425-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL-1333390200000X
CO46265207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO69654743Medicaid
CO69654743Medicaid