Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 15525 | CO |
NPI | 1003892076 |
---|---|
Provider Name | Dr. Freeman Miles Ginsburg |
First Address | Aurora, CO 80014-3518 |
Second Address | Centennial, CO 80015-5307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 10/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01155258 | (05) | CO |
D22871 | (02) |