Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 39454 | CO |
Y | 207VE0102X | Reproductive Endocrinologist | 39454 | CO |
NPI | 1073616926 |
---|---|
Provider Name | Deborah Smith |
First Address | Englewood, CO 80112-4128 |
Second Address | Englewood, CO 80112-4128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 25/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
28703243 | (05) | CO |
E37721 | (02) |