Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | DR.0052259 | CO |
N | 208000000X | Pediatrician | DR.0052259 | CO |
N | 2080P0205X | Pediatric Endocrinologist | DR.0052259 | CO |
NPI | 1710203229 |
---|---|
Provider Name | Shanlee Marie Davis |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2010 |
Last Update Date | 19/11/2018 |