Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 41294 | CO |
NPI | 1003914599 |
---|---|
Provider Name | Suzanne Weber |
First Address | Littleton, CO 80122 |
Second Address | Littleton, CO 80122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 11/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
72900512 | (05) | CO |
H89561 | (02) | CO |