Provider Demographics
NPI:1851468276
Name:NASH, ALFRED ERED JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:ERED
Last Name:NASH
Suffix:JR
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 1:2121 S BLACKHAWK ST STE 110
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1488
Mailing Address - Country:US
Mailing Address - Phone:303-353-2530
Mailing Address - Fax:720-535-4821
Practice Address - Street 1:2121 S BLACKHAWK ST STE 110
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1488
Practice Address - Country:US
Practice Address - Phone:303-353-2530
Practice Address - Fax:720-535-4821
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37668207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO021999OtherKAISER COMMERCIAL NUMBER
CO840770897OtherTAX ID
CO76531252Medicaid
CO76531252Medicaid
COCOAAA0917Medicare PIN
CO475228Medicare ID - Type Unspecified