Provider Demographics
NPI:1003303173
Name:MOSHER, JEREMY M (DO, MPH)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:M
Last Name:MOSHER
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 ARGONNE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-6836
Mailing Address - Country:US
Mailing Address - Phone:303-649-3750
Mailing Address - Fax:303-649-3751
Practice Address - Street 1:4809 ARGONNE ST STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-6836
Practice Address - Country:US
Practice Address - Phone:303-649-3750
Practice Address - Fax:303-649-3751
Is Sole Proprietor?:No
Enumeration Date:2018-04-15
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02006458A207Q00000X
390200000X
CODR.73524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program