Provider Demographics
NPI:1104925635
Name:HARADA, RUTH N (MD)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:N
Last Name:HARADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E 19TH AVE
Mailing Address - Street 2:SUITE 4450
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1216
Mailing Address - Country:US
Mailing Address - Phone:303-830-2900
Mailing Address - Fax:303-830-2901
Practice Address - Street 1:10701 MELODY DR
Practice Address - Street 2:SUITE 500
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4130
Practice Address - Country:US
Practice Address - Phone:303-280-2882
Practice Address - Fax:303-280-2876
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20603174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01206036Medicaid
CO01206036Medicaid
COC149928Medicare ID - Type Unspecified