Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 21414 | CO |
N | 207QA0401X | Family Doctor - Addiction Medicine | 21414 | CO |
NPI | 1649210329 |
---|---|
Provider Name | Caroline M Gellrick |
First Address | Denver, CO 80291-0557 |
Second Address | Wheat Ridge, CO 80033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 30/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01214147 | (05) | CO |
080114815 | MEDICARE RAILROAD (01) | |
D84544 | (02) |