Bertoldo, Fred Jeffrey

Bertoldo, Fred Jeffrey is an individual health care provider with primary practice located at 1619 N Greenwood St Suite 103, Pueblo CO 81003-2644. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Bertoldo, Fred Jeffrey can be contacted via phone (719) 542-2167.

Contact Information

Primary practice address
1619 N Greenwood St Suite 103 Pueblo CO 81003-2644
Phone: (719) 542-2167
Fax: (719) 542-0320
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 35094 Colorado
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 35094 Colorado

Profile Details

NPI number 1548216443
LBN Legal business name Bertoldo, Fred Jeffrey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Apr 17th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548216443 NPPES
Colorado MEDICAID 01350941

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