Provider Demographics
NPI:1235484684
Name:CHERRY CREEK NEUROLOGY
Entity Type:Organization
Organization Name:CHERRY CREEK NEUROLOGY
Other - Org Name:AMENT HEADACHE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:AMENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-834-5677
Mailing Address - Street 1:1720 S. BELLAIRE ST. STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222
Mailing Address - Country:US
Mailing Address - Phone:303-384-5677
Mailing Address - Fax:303-835-0730
Practice Address - Street 1:1720 S. BELLAIRE ST. STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222
Practice Address - Country:US
Practice Address - Phone:303-384-5677
Practice Address - Fax:303-835-0730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-20
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty