Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 27928 | CO |
NPI | 1013916881 |
---|---|
Provider Name | Mr. Charles Herbert Ripp |
First Address | Greenwood Village, CO 80111-4727 |
Second Address | Colorado Springs, CO 80920-7502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 22/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01279280 | (05) | CO |
E04730 | (02) |