Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | DR.0064390 | CO |
N | 208200000X | Surgeon | DR.0064390 | CO |
N | 208600000X | Surgeon | DR.0064390 | CO |
N | 2082S0105X | Plastic Hand Surgeon | DR.0064390 | CO |
NPI | 1457549446 |
---|---|
Provider Name | Dr. Ryan Douglas Endress |
First Address | Englewood, CO 80113-2769 |
Second Address | Englewood, CO 80113-2769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2007 |
Last Update Date | 09/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DR.0064390 | MEDICAL LICENSE (01) | CO |