Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 41259 | CO |
NPI | 1053360792 |
---|---|
Provider Name | Dr. David Scott Miner |
First Address | Denver, CO 80210-2121 |
Second Address | Wheat Ridge, CO 80033-6005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 22/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
58602232 | (05) | CO |
H84608 | (02) | CO |