Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 46723 | CO |
N | 207VG0400X | Gynecologist | DR-46723 | CO |
NPI | 1205095403 |
---|---|
Provider Name | Elizabeth S Ehama |
First Address | Denver, CO 80256-0825 |
Second Address | Pueblo, CO 81001-1045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 07/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03705854 | (05) | CO |