Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 43564 | CO |
NPI | 1093874307 |
---|---|
Provider Name | Dr. Stephanie Todd |
First Address | Denver, CO 80218-1007 |
Second Address | Aurora, CO 80045-5701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
68027389 | (05) | CO |
I49825 | (02) | CO |