Provider Demographics
NPI:1104053495
Name:DEARSTYNE, NADIA M (MD)
Entity type:Individual
Prefix:DR
First Name:NADIA
Middle Name:M
Last Name:DEARSTYNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NADIA
Other - Middle Name:S
Other - Last Name:MARKOVCHICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1375 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1114
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT195609207P00000X
CODR.0050907207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO022748OtherKAISER COMMERCIAL NUMBER
CO39057216Medicaid
CO39057216Medicaid