Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 16815 | CO |
NPI | 1235199456 |
---|---|
Provider Name | William W Storms |
First Address | Colo Springs, CO 80907 |
Second Address | Colo Springs, CO 80907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01168152 | (05) | CO |
D23135 | (02) |