Provider Demographics
NPI:1902863541
Name:OSTER, HEIDI JO (MD)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:JO
Last Name:OSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:HEIDI
Other - Middle Name:JO
Other - Last Name:JATANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10099 RIDGE GATE PARKWAY, SUITE 280
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124
Mailing Address - Country:US
Mailing Address - Phone:303-791-2112
Mailing Address - Fax:303-683-6415
Practice Address - Street 1:10099 RIDGE GATE PARKWAY, SUITE 280
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124
Practice Address - Country:US
Practice Address - Phone:303-791-2112
Practice Address - Fax:303-683-6415
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37061207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53704258Medicaid
CO53704258Medicaid
F11577Medicare UPIN