Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | DR.0036239 | CO |
N | 208000000X | Pediatrician | 15310 | HI |
NPI | 1003893843 |
---|---|
Provider Name | Richard W. Penland |
First Address | Denver, CO 80217-0284 |
Second Address | Aurora, CO 80012-5411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 27/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01362391 | (05) | CO |
G51972 | (02) | CO |