Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 81342 | AZ |
N | 111NI0900X | Internist | 81342 | AZ |
N | 207R00000X | Internist | DR.0062745 | CO |
N | 111NI0900X | Internist | DR.0062745 | CO |
Y | 207RG0100X | Gastroenterologist | DR.0062745 | CO |
N | 207RG0100X | Gastroenterologist | P6432 | TX |
NPI | 1013113547 |
---|---|
Provider Name | Dr. Veronika Panah |
First Address | Colorado Springs, CO 80907-6262 |
Second Address | Greeley, CO 80631-5188 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2007 |
Last Update Date | 24/07/2019 |