Provider Demographics
NPI:1679510077
Name:BARONBERG, NEIEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIEL
Middle Name:D
Last Name:BARONBERG
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 1:2480 S DOWNING ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5890
Mailing Address - Country:US
Mailing Address - Phone:303-777-5455
Mailing Address - Fax:303-777-1175
Practice Address - Street 1:2480 S DOWNING ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5890
Practice Address - Country:US
Practice Address - Phone:303-777-5455
Practice Address - Fax:303-777-1175
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17261174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28606OtherBLUE CROSS
CO840826594001OtherROCKY MTN HEALTH
CO01172618Medicaid
CO920523OtherPACIFICARE/EYE SPECIALIST
CO840826594001OtherROCKY MTN HEALTH
COC6751Medicare PIN