Provider Demographics
NPI:1821294554
Name:ESBERG, LUCY B (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:B
Last Name:ESBERG
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 1:4900 S MONACO ST
Mailing Address - Street 2:STE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-750-0822
Mailing Address - Fax:303-750-1298
Practice Address - Street 1:1444 S POTOMAC ST
Practice Address - Street 2:STE 300
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4510
Practice Address - Country:US
Practice Address - Phone:303-750-0822
Practice Address - Fax:303-750-1298
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2330207R00000X
CO48843207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO89280571Medicaid
CO318402YPNQMedicare PIN
COP01262148Medicare PIN