Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | DR.0037818 | CO |
N | 111NI0900X | Internist | DR.0037818 | CO |
N | 207RC0200X | Critical Care Medicine | DR.0037818 | CO |
Y | 207RP1001X | Pulmonary Disease | DR.0037818 | CO |
NPI | 1023088945 |
---|---|
Provider Name | Dr. Diana M Breyer |
First Address | Fort Collins, CO 80528-3400 |
Second Address | Fort Collins, CO 80528-3400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 16/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114261500 | (05) | WY |
17584281 | (05) | CO |
290012386 | RAILROAD MEDICARE (01) | CO |
G49722 | (02) | CO |