Provider Demographics
NPI:1871658393
Name:GILDER, BEVERLY FAYE (MD)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:FAYE
Last Name:GILDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 17528
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-0528
Mailing Address - Country:US
Mailing Address - Phone:405-682-3303
Mailing Address - Fax:405-384-6793
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:SUITE 360
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2780
Practice Address - Country:US
Practice Address - Phone:303-781-4485
Practice Address - Fax:720-274-0064
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO314272084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01314277Medicaid
COC34191Medicare PIN
CO841254979OtherEIN