Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CHR.0008363 | CO |
NPI | 1407426679 |
---|---|
Provider Name | Dr. Brad Debeer |
First Address | Wheat Ridge, CO 80033-1946 |
Second Address | Wheat Ridge, CO 80033-1946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2021 |
Last Update Date | 29/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CHR.0008363 | COLORADO DEPT. OF REGULATORY AGENCIES (01) | CO |
EL.2787245 | COLORADO DEPT. OF REGULATORY AGENCIES (01) | CO |