Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 52177 | CO |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | DR.0052177 | CO |
NPI | 1396919858 |
---|---|
Provider Name | Dr. Stephanie Watson Mayer |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 29/11/2018 |