Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 31736 | CO |
NPI | 1073596524 |
---|---|
Provider Name | Dr. Michele M Chetham |
First Address | Denver, CO 80237-3487 |
Second Address | Centennial, CO 80112-4045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007828 | KAISER COMMERCIAL NUMBER (01) | CO |
01317361 | (05) | CO |
122626600 | (05) | WY |