Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 27973 | CO |
NPI | 1679523229 |
---|---|
Provider Name | Dr. Joel Alan Berenbeim |
First Address | Wheat Ridge, CO 80033-3877 |
Second Address | Denver, CO 80222-6025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 08/07/2007 |