Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 2940 | GA |
N | 2086S0120X | Pediatric Surgery | PA06207 | TX |
NPI | 1508812629 |
---|---|
Provider Name | Todd J Pillen |
First Address | Denver, CO 80210-5847 |
Second Address | Denver, CO 80210-5847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 16/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
098802401 | (05) | TX |