Provider Demographics
NPI:1194742981
Name:HONEA, BERTRAND NEEDHAM (MD)
Entity type:Individual
Prefix:DR
First Name:BERTRAND
Middle Name:NEEDHAM
Last Name:HONEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 LOGAN CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3100
Mailing Address - Country:US
Mailing Address - Phone:970-290-2071
Mailing Address - Fax:
Practice Address - Street 1:945 LOGAN CT
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3100
Practice Address - Country:US
Practice Address - Phone:970-290-2071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22880207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01-228808Medicaid
COE41599Medicare UPIN