MALDEN, ERIC (MD)

Provider Demographics

• NPI: 1356395792
• Name: MALDEN, ERIC (MD)
• Entity type: Individual
• First Name: ERIC
• Last Name: MALDEN
• Gender: M
• Credentials: MD
• Mailing Address - Street 1: 10800 E GEDDES AVE STE 300
• Mailing Address - City: ENGLEWOOD
• Mailing Address - State: CO
• Mailing Address - Zip Code: 80112-3895
• Mailing Address - Country: US
• Mailing Address - Phone: 303-761-9190
• Mailing Address - Fax: 720-874-4462
• Practice Address - Street 1: 501 E HAMPDEN AVE
• Practice Address - City: ENGLEWOOD
• Practice Address - State: CO
• Practice Address - Zip Code: 80113-2702
• Practice Address - Country: US
• Practice Address - Phone: 303-761-9190
• Practice Address - Fax: 720-987-4446
• Is Sole Proprietor?: No
• Enumeration Date: 2006-05-20
• Last Update Date: 2024-03-29

Provider Licenses

State	License ID	Taxonomies
HI	MD17554	2085R0202X
NE	25094	2085R0202X
KS	04-36274	2085R0202X
CO	38361	2085R0202X
CO	DR.0038361	2085R0204X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0204X	Allopathic & Osteopathic Physicians	Radiology	Vascular & Interventional Radiology
No	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
CO	CO306497	Other	MCR TB MIC
OK	200025620A	Medicaid
SC	Q38361	Medicaid
NE	10025709000	Medicaid
AZ	373313	Medicaid
NM	11451581	Medicaid
IA	1356395792	Medicaid
WY	1356395792	Medicaid
MT	1356395792	Medicaid
SD	1356395792	Medicaid
CO	300111554	Other	RR RIA MEDICARE
NE	NA1215044	Other	WPS MCR NE
MI	104686267	Medicaid
NE	84-059792913	Medicaid
KS	200254280A	Medicaid
CO	300111551	Other	RR MIC MEDICARE
CO	97624349	Medicaid
NE	NA1214044	Other	WPS MCR NE
CO	CO306497	Other	MCR TB MIC
KS	200254280A	Medicaid
AZ	373313	Medicaid
SD	1356395792	Medicaid
NE	10025709000	Medicaid
CO	394417ZLJ3	Medicare PIN
	P00779033	Medicare PIN
NE	NA1215044	Other	WPS MCR NE
NE	NA1214044	Other	WPS MCR NE
CO	97624349	Medicaid
CO	C22644	Medicare PIN