Provider Demographics
NPI:1558980011
Name:POLSDOFER, ERIK VON (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:VON
Last Name:POLSDOFER
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:ACADEMIC OFFICE 1 DEPARTMENT OF PATHOLOGY
Mailing Address - Street 2:12631 EAST 17TH AVENUE MAILSTOP B216
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045
Mailing Address - Country:US
Mailing Address - Phone:303-724-3483
Mailing Address - Fax:
Practice Address - Street 1:ACADEMIC OFFICE 1; DEPARTMENT OF PATHOLOGY
Practice Address - Street 2:12631 EAST 17TH AVENUE
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:303-724-3483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL.0008234390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program