Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 48641 | CO |
N | 2080P0207X | Pediatric Hematology-Oncologist | A80230 | CA |
NPI | 1194970350 |
---|---|
Provider Name | Dr. John A Van Doorninck |
First Address | Denver, CO 80237-3486 |
Second Address | Denver, CO 80205-5503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2008 |
Last Update Date | 31/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06207219 | (05) | NM |
10025570100 | (05) | NE |
1194970350 | (05) | SD |
1194970350 | (05) | WY |
98500546 | (05) | CO |