Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 37072 | CO |
NPI | 1053335166 |
---|---|
Provider Name | James Michael Martau |
First Address | Denver, CO 80291-1057 |
Second Address | Westminster, CO 80031-3844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 03/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
86052357 | (05) | CO |
G85007 | (02) |