Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 50313 | CO |
NPI | 1295898187 |
---|---|
Provider Name | Dr. Ryan Andrew Gaines |
First Address | Denver, CO 80210-5847 |
Second Address | Denver, CO 80210-5855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 16/10/2019 |