Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 51307 | CO |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 2011006545 | MO |
NPI | 1093013500 |
---|---|
Provider Name | Dr. Michael Rashad Booker |
First Address | Denver, CO 80247-1314 |
Second Address | Denver, CO 80205-5437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2011 |
Last Update Date | 09/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005841 | KAISER COMMERCIAL NUMBER (01) | CO |
40226352 | (05) | CO |