Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | DR.0057358 | CO |
N | 208200000X | Surgeon | 77554 | MA |
N | 208600000X | Surgeon | 77554 | MA |
NPI | 1457331738 |
---|---|
Provider Name | James Pomposelli |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 22/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3136582 | (05) | MA |
G22280 | (02) |