Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 47414 | CO |
Y | 208200000X | Surgeon | 47414 | CO |
Y | 208600000X | Surgeon | 47414 | CO |
NPI | 1285606764 |
---|---|
Provider Name | Dr. Frederic White-Brown Deleyiannis |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 15/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
61135542 | (05) | CO |
H03250 | (02) | PA |