Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 56333 | CO |
N | 208000000X | Pediatrician | 042.0012605 | VT |
Y | 2080P0203X | Pediatric Critical Care Doctor | DR.0056333 | CO |
NPI | 1124343108 |
---|---|
Provider Name | Ryan John Good |
First Address | Denver, CO 80206-2761 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2010 |
Last Update Date | 17/03/2018 |