Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 31796 | CO |
NPI | 1215045133 |
---|---|
Provider Name | Andrew W Parker |
First Address | Denver, CO 80220-4053 |
Second Address | Denver, CO 80220-4053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 24/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01317965 | (05) | CO |
E83678 | (02) | CO |