Provider Demographics
NPI:1174587109
Name:HO, EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:HO
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:PO BOX 460041
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-0041
Mailing Address - Country:US
Mailing Address - Phone:303-722-2724
Mailing Address - Fax:303-722-3121
Practice Address - Street 1:850 E HARVARD AVE
Practice Address - Street 2:SUITE 455
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5073
Practice Address - Country:US
Practice Address - Phone:303-722-2724
Practice Address - Fax:303-722-3121
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37440207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO78501571Medicaid
COC43381Medicare PIN
G92820Medicare UPIN