Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 41523 | CO |
NPI | 1326064353 |
---|---|
Provider Name | Dr. Maria T Gentile |
First Address | Denver, CO 80212-2025 |
Second Address | Denver, CO 80212-2025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 10/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20437900301 | PACIFICARE (01) | CO |
20437900380113 | CHAMPUS WEST REGION (01) | CO |
612568700 | ACS DEPT OF LABOR (01) | CO |
GE5788 | BLUE CROSS BLUE SHIELD (01) | CO |
H-90518 | (02) | CO |