Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | DO034505 | DC |
Y | 111NI0900X | Internist | DO034505 | DC |
NPI | 1003172446 |
---|---|
Provider Name | Philip Andreoli |
First Address | Denver, CO 80204 |
Second Address | Denver, CO 80204-4507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2012 |
Last Update Date | 21/09/2017 |