Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 24921 | CO |
Y | 208600000X | Surgeon | 24921 | CO |
NPI | 1003843012 |
---|---|
Provider Name | Deborah K Davis-Merritt |
First Address | Denver, CO 80211-5301 |
Second Address | Denver, CO 80218-3670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 25/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01249218 | (05) | CO |
F15643 | (02) | |
P00190583 | MEDICARE RAILROAD (01) |