Provider Demographics
NPI:1386743441
Name:WALDBAUM, ARTHUR S (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:S
Last Name:WALDBAUM
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 1:1201 E 17TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1574
Mailing Address - Country:US
Mailing Address - Phone:303-298-0222
Mailing Address - Fax:303-298-1023
Practice Address - Street 1:1201 E 17TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1574
Practice Address - Country:US
Practice Address - Phone:303-298-0222
Practice Address - Fax:303-298-1023
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO19509207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01195099Medicaid
CO01195099Medicaid
COC93101Medicare ID - Type Unspecified