Provider Demographics
NPI:1295997740
Name:HAGER, BARBARA EWA (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:EWA
Last Name:HAGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:EWA
Other - Last Name:ZERDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 15TH ST
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-4500
Mailing Address - Country:US
Mailing Address - Phone:970-350-5612
Mailing Address - Fax:970-350-5619
Practice Address - Street 1:2315 E HARMONY RD STE 110
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-8623
Practice Address - Country:US
Practice Address - Phone:970-482-4373
Practice Address - Fax:970-484-5682
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT193040207R00000X
IL036.1298792084N0600X
DC390200000X
CODR.00526242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO349280YLB8OtherMEDICARE