Provider Demographics
NPI:1487636775
Name:MARDER, BRAD A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:A
Last Name:MARDER
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 1:20 S TRENTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6993
Mailing Address - Country:US
Mailing Address - Phone:303-909-2256
Mailing Address - Fax:
Practice Address - Street 1:130 RAMPART WAY STE 300B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6451
Practice Address - Country:US
Practice Address - Phone:303-327-4700
Practice Address - Fax:303-327-4711
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41606207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO54504368Medicaid
COH80545Medicare UPIN
CO54504368Medicaid