Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 23280 | NE |
Y | 207T00000X | Neurosurgeon | 52461 | CO |
NPI | 1013966001 |
---|---|
Provider Name | Dr. Peter J Lennarson |
First Address | Denver, CO 80205-5437 |
Second Address | Denver, CO 80205-5437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 08/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023407 | KAISER COMMERCIAL NUMBER (01) | CO |
47078557581 | (05) | NE |
87629267 | (05) | CO |
G85227 | (02) | NE |