Ellis Sam Fishman
Geriatric Medicine
3885 Upham St 100
Wheat Ridge
, Colorado 80033-4880
Ellis Sam Fishman
Geriatric Medicine
3885 Upham St 100
Wheat Ridge
, Colorado 80033-4880
(303) 742-0690
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Ellis Sam Fishman
- 3885 Upham St 100
- Wheat Ridge, CO
- Zip : 80033-4880
- Fax : (303) 742-0690
- Phone : (303) 742-0108
Second Address
- Ellis Sam Fishman
- 3885 Upham St 100
- Wheat Ridge, CO
- Zip : 80033-4880
- Fax : (303) 742-0690
- Phone : (303) 742-0108
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | 14519 | CO |
National Provider Identifier
| NPI | 1144335696 |
|---|---|
| Provider Name | Ellis Sam Fishman |
| First Address | Wheat Ridge, CO 80033-4880 |
| Second Address | Wheat Ridge, CO 80033-4880 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/08/2006 |
| Last Update Date | 07/04/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1144335696 | (05) | CO |
| C80089 | (02) | CO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.