Provider Demographics
NPI:1104851351
Name:ARENSON, EDWARD B (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:B
Last Name:ARENSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1610 LITTLE RAVEN ST
Mailing Address - Street 2:UNIT 410
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-6178
Mailing Address - Country:US
Mailing Address - Phone:720-389-7749
Mailing Address - Fax:720-389-7749
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:STE 450
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3878
Practice Address - Country:US
Practice Address - Phone:720-389-7749
Practice Address - Fax:720-519-0229
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2017-11-06
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Provider Licenses
StateLicense IDTaxonomies
CO182992080P0207X
261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Single Specialty
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09759867Medicaid
COB82101Medicare UPIN
COC4571Medicare ID - Type Unspecified