Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 21719 | CO |
N | 111NI0900X | Internist | 21719 | CO |
Y | 207RC0200X | Critical Care Medicine | 21719 | CO |
N | 207RP1001X | Pulmonary Disease | 21719 | CO |
NPI | 1063482982 |
---|---|
Provider Name | Dr. Stanley Gunstream |
First Address | Loveland, CO 80538-8702 |
Second Address | Fort Collins, CO 80528-3400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 26/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063482982 | (05) | CO |
290007465 | RAILROAD MEDICARE (01) | CO |
D23978 | (02) | CO |