Provider Demographics
NPI:1417968454
Name:EULBERG, MARNY KAY (MD)
Entity Type:Individual
Prefix:
First Name:MARNY
Middle Name:KAY
Last Name:EULBERG
Suffix:
Gender:F
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:DEPT 1057
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1057
Mailing Address - Country:US
Mailing Address - Phone:303-486-5504
Mailing Address - Fax:303-486-5501
Practice Address - Street 1:8510 BRYANT ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3844
Practice Address - Country:US
Practice Address - Phone:303-430-5560
Practice Address - Fax:303-430-5565
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19393207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01193937Medicaid
D23601Medicare UPIN
C302068Medicare ID - Type Unspecified