Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 39484 | CO |
NPI | 1023058047 |
---|---|
Provider Name | Dr. Jeffrey Alan Gunter |
First Address | Denver, CO 80211-4202 |
Second Address | Boulder, CO 80301-1396 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 01/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40505073 | (05) | CO |