Provider Demographics
NPI:1154451367
Name:ASPEN MEDICAL CARE, PC
Entity Type:Organization
Organization Name:ASPEN MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEUER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-920-0104
Mailing Address - Street 1:101 FOUNDERS PL
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1476
Mailing Address - Country:US
Mailing Address - Phone:970-920-0104
Mailing Address - Fax:970-920-0124
Practice Address - Street 1:101 FOUNDERS PL
Practice Address - Street 2:SUITE 109
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1476
Practice Address - Country:US
Practice Address - Phone:970-920-0104
Practice Address - Fax:970-920-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
J5308Medicare ID - Type Unspecified