Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | DR.0048123 | CO |
N | 208000000X | Pediatrician | 0420011158 | VT |
N | 208000000X | Pediatrician | 48123 | CO |
NPI | 1679809131 |
---|---|
Provider Name | Megan Corina Lucero |
First Address | Denver, CO 80217-0284 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2009 |
Last Update Date | 29/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RES000 | (02) |