Individual
DR. MIRA EKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
455 ACOMA ST, DENVER, CO 80204-5112
(303) 780-9191
(303) 780-9192
Mailing address
455 ACOMA ST, DENVER, CO 80204-5112
(303) 780-9191
(303) 780-9192
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
42236
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89228723
—
CO
01
—
COA100797
MEDICARE PTAN
CO
Enumeration date
01/17/2007
Last updated
01/26/2015
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