Healthcare Provider Details

I. General information

NPI: 1922233196
Provider Name (Legal Business Name): GLOBAL TRAVEL HEALTH PROFESSIONAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 E 9TH AVE STE 120
DENVER CO
80220-3902
US

IV. Provider business mailing address

4545 E 9TH AVE STE 120
DENVER CO
80220-3902
US

V. Phone/Fax

Practice location:
  • Phone: 303-468-6986
  • Fax: 303-320-1953
Mailing address:
  • Phone: 303-468-6986
  • Fax: 303-320-1953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number30415
License Number StateCO

VIII. Authorized Official

Name: DR. JOHN HAMMER
Title or Position: 34 OWNER
Credential: M.D.
Phone: 303-468-6986