Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | DR.0061258 | CO |
N | 207WX0107X | Retina Specialist | DR.0061258 | CO |
NPI | 1003170366 |
---|---|
Provider Name | Dr. Abed Namavari |
First Address | Greenwood Village, CO 80111-4747 |
Second Address | Greenwood Village, CO 80111-4747 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2012 |
Last Update Date | 22/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9000169744 | (05) | CO |