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NPI Code Detail

MEDICARE: DR. AMY CLINE HERMESCH M.D., PH.D.

MEDICARE:  DR. AMY CLINE HERMESCH  M.D., PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianDR.0052034CO
2390200000XStudent in an Organized Health Care Education/Training Program
3207VM0101XMaternal & Fetal Medicine PhysicianMD182421OR

General Provider Information

NPI Number : 1720220841
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMY CLINE HERMESCH M.D., PH.D.
Provider Business Mailing Address
First Line : PO BOX 110429
Second Line :
City : AURORA
State : CO
Zip : 80042-0429
Country : US
Telephone Number : 303-493-7000
Fax Number :
Provider Business Practice Location Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3011
Country : US
Telephone Number : 503-494-2101
Fax Number : 503-494-5296
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2009
Last Update Date : 11/14/2018

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