Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 22341 | CO |
NPI | 1033175591 |
---|---|
Provider Name | Mr. James Michael Mcgowan |
First Address | Aurora, CO 80014-6318 |
Second Address | Aurora, CO 80014-6318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 26/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01223411 | (05) | CO |
D24082 | (02) |