Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 44872 | CO |
NPI | 1144305376 |
---|---|
Provider Name | Abdulrahman S Alsultan |
First Address | Denver, CO 80206-2761 |
Second Address | Denver, CO 80206-2761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BA8998051 | DEA (01) | CO |
I2795 | (02) | CO |