Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 39106 | CO |
NPI | 1003898883 |
---|---|
Provider Name | James Trevor Mcnutt |
First Address | Denver, CO 80220-3901 |
Second Address | Denver, CO 80220-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 05/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H72875 | (02) | CO |