Provider Demographics
NPI:1184879272
Name:HEALEY, EDWIN MACK (MD)
Entity type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:MACK
Last Name:HEALEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3865 CHERRY CREEK DRIVE NORTH
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209
Mailing Address - Country:US
Mailing Address - Phone:720-379-8530
Mailing Address - Fax:720-379-8530
Practice Address - Street 1:3865 CHERRY CREEK DRIVE NORTH
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209
Practice Address - Country:US
Practice Address - Phone:720-379-8530
Practice Address - Fax:720-379-8530
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COC0232302084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine