Healthcare Provider Details

I. General information

NPI: 1720011331
Provider Name (Legal Business Name): SAMUEL D. NORTMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WHEELING ST # 117
AURORA CO
80045-7211
US

IV. Provider business mailing address

1700 WHEELING ST # 117
AURORA CO
80045-7211
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax:
Mailing address:
  • Phone: 303-399-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberDR.0045916
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberDR.0045916
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberDR.0045916
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: