Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 13951 | CO |
NPI | 1013041730 |
---|---|
Provider Name | Mr. Samuel William Downing IV |
First Address | Salida, CO 81201-0126 |
Second Address | Salida, CO 81201-0126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01139518 | (05) | CO |