Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | DR33960 | CO |
NPI | 1457378275 |
---|---|
Provider Name | Dr. Alan Ray Brautigam |
First Address | Aurora, CO 80014-1927 |
Second Address | Denver, CO 80220-3808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 08/07/2007 |