Provider Demographics
NPI:1003170366
Name:NAMAVARI, ABED (MD)
Entity Type:Individual
Prefix:DR
First Name:ABED
Middle Name:
Last Name:NAMAVARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6021 S SYRACUSE WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4747
Mailing Address - Country:US
Mailing Address - Phone:720-667-3852
Mailing Address - Fax:303-648-6462
Practice Address - Street 1:6021 S SYRACUSE WAY STE 102
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4747
Practice Address - Country:US
Practice Address - Phone:720-667-3852
Practice Address - Fax:303-648-6462
Is Sole Proprietor?:No
Enumeration Date:2012-07-01
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0061258207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000169744Medicaid