Provider Demographics
NPI:1114189057
Name:ARETE NEUROSURGICAL PC
Entity Type:Organization
Organization Name:ARETE NEUROSURGICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RENATTA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTERDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-832-2449
Mailing Address - Street 1:9450 VISTA HILL LN
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-8471
Mailing Address - Country:US
Mailing Address - Phone:303-374-4224
Mailing Address - Fax:
Practice Address - Street 1:1601 E 19TH AVE STE 4600
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1289
Practice Address - Country:US
Practice Address - Phone:303-832-2449
Practice Address - Fax:303-832-3832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46246207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27771849Medicaid