Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 44898 | CO |
NPI | 1023164621 |
---|---|
Provider Name | Peter D'ambrosia |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 18/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11671882 | (05) | CO |