Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 22232 | CO |
Y | 111NI0900X | Internist | 22232 | CO |
NPI | 1003804931 |
---|---|
Provider Name | Dr. Alan W Burgess |
First Address | Denver, CO 80237-3486 |
Second Address | Denver, CO 80218-1293 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 15/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01222322 | (05) | CO |
D24056 | (02) | CO |