Provider Demographics
NPI:1386635878
Name:HALTERMAN, RICHARD K (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:K
Last Name:HALTERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4891 INDEPENDENCE ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6752
Mailing Address - Country:US
Mailing Address - Phone:303-456-5495
Mailing Address - Fax:303-456-7490
Practice Address - Street 1:2655 CRESENCT DRIVE
Practice Address - Street 2:SUITE C
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3376
Practice Address - Country:US
Practice Address - Phone:303-443-4200
Practice Address - Fax:303-443-5470
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2008-10-22
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Provider Licenses
StateLicense IDTaxonomies
CO34598207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01345982Medicaid
CO390005664OtherRR MEDICARE
CO01345982Medicaid
C225738Medicare PIN