| Colorado Neurology Center Pllc | |
|
1400 S. Potomac St #220 Aurora CO 80012-4522 | |
| (720) 248-5200 | |
| (720) 248-5201 |
| Full Name | Colorado Neurology Center Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1400 S. Potomac St, Aurora, Colorado |
| Authorized Official Name and Position | Simon C Oh (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3034810030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colorado Neurology Center Pllc 1400 S. Potomac St #220 Aurora CO 80012-4522 Ph: (720) 248-5200 | Colorado Neurology Center Pllc 1400 S. Potomac St #220 Aurora CO 80012-4522 Ph: (720) 248-5200 |
| NPI Number | 1851796627 |
|---|---|
| Provider Enumeration Date | 10/23/2014 |
| Last Update Date | 01/30/2015 |
| Medicare PECOS PAC ID | 9830413335 |
|---|---|
| Medicare Enrollment ID | O20150109000993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851796627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 49292 (Colorado) | Primary |
| Provider Name | Simon C Oh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649236191 PECOS PAC ID: 2567539935 Enrollment ID: I20110124001081 |
| Provider Name | Deirdre B Fraller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386908861 PECOS PAC ID: 3971751496 Enrollment ID: I20170411002520 |
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