Provider Demographics
NPI:1184607012
Name:KERSTEIN, HOWARD J (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:J
Last Name:KERSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HOWARD
Other - Middle Name:J
Other - Last Name:KERSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3865 CHERRY CREEK DRIVE NORTH
Mailing Address - Street 2:#322
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:303-394-2888
Mailing Address - Fax:303-322-0475
Practice Address - Street 1:3865 CHERRY CREEK DRIVE NORTH
Practice Address - Street 2:#322
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209
Practice Address - Country:US
Practice Address - Phone:303-394-2888
Practice Address - Fax:303-322-0475
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15566174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01155662Medicaid
CO01155662Medicaid
COD22882Medicare UPIN