Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | DR.0062764 | CO |
N | 2080P0216X | Pediatric Rheumatologist | DR.0062764 | CO |
NPI | 1851753602 |
---|---|
Provider Name | Dr. Jareau Cordell |
First Address | Aurora, CO 80045-7106 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 16/07/2019 |