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Individual

EDWARD SHUHERK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12790 W ALAMEDA PKWY, LAKEWOOD, CO 80228-2859
(303) 403-6350
(303) 403-6372
Mailing address
12790 W ALAMEDA PKWY, LAKEWOOD, CO 80228-2859
(303) 403-6350
(303) 403-6372

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37303
IA
207Q00000X
Family Medicine Physician
R7704
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0469940
IA
05
1033166251
IA
01
P00741121
RR MEDICARE
IA
Enumeration date
05/31/2006
Last updated
06/06/2019
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