Provider Demographics
NPI:1164685228
Name:ASHEROV, LEV (MD)
Entity Type:Individual
Prefix:DR
First Name:LEV
Middle Name:
Last Name:ASHEROV
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 1:1600 N GRAND AVE
Mailing Address - Street 2:SUITE 245
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2731
Mailing Address - Country:US
Mailing Address - Phone:719-595-7700
Mailing Address - Fax:719-595-7719
Practice Address - Street 1:1600 N GRAND AVE
Practice Address - Street 2:SUITE 245
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2731
Practice Address - Country:US
Practice Address - Phone:719-595-7700
Practice Address - Fax:719-595-7719
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47430207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine