Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | C10002595 | DE |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | C10002595 | DE |
NPI | 1073590287 |
---|---|
Provider Name | Garrett Hc Colmorgen |
First Address | Dover, DE 19901-3530 |
Second Address | Dover, DE 19904-6920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 03/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B66337 | (02) | DE |
BC2796691 | DEA (01) | DE |
C10002595 | DE MEDICAL LICENSE (01) | DE |
MD 1397 | DE CDS (01) | DE |