Provider Demographics
NPI:1598745366
Name:PRICE, BRENDA C (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:C
Last Name:PRICE
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 1:5450 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2709
Mailing Address - Country:US
Mailing Address - Phone:303-441-0587
Mailing Address - Fax:303-996-0801
Practice Address - Street 1:4745 ARAPAHOE AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1080
Practice Address - Country:US
Practice Address - Phone:303-441-0587
Practice Address - Fax:303-996-0801
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0045835207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18633048Medicaid
COC809616Medicare PIN
0000252004205OtherUNITED
10002624OtherOPTIMA HEALTH
417630OtherSOUTHERN HEALTH
186202OtherANTHEM
009905563Medicare PIN
541941044002OtherTRICARE
10002624OtherSENTARA
60984OtherCARENET
5041856OtherCIGNA
7224625OtherAETNA USHEALTH
2145504OtherMAMSI
127266Medicare UPIN