Provider Demographics
NPI:1265491757
Name:ARTHUR S WALDBAUM MD PC
Entity type:Organization
Organization Name:ARTHUR S WALDBAUM MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:WALDBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-298-0222
Mailing Address - Street 1:1201 E 17TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1574
Mailing Address - Country:US
Mailing Address - Phone:303-298-0222
Mailing Address - Fax:303-298-1023
Practice Address - Street 1:1201 E 17TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1574
Practice Address - Country:US
Practice Address - Phone:303-298-0222
Practice Address - Fax:303-298-1023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19509207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01195098Medicaid
CO93101Medicare ID - Type Unspecified
D23619Medicare UPIN