Healthcare Provider Details

I. General information

NPI: 1912911017
Provider Name (Legal Business Name): ANKIE MARIE AMOS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 JACKSON ST
DENVER CO
80206
US

IV. Provider business mailing address

1400 JACKSON ST
DENVER CO
80206-2762
US

V. Phone/Fax

Practice location:
  • Phone: 303-388-4461
  • Fax: 303-270-2206
Mailing address:
  • Phone: 303-388-4461
  • Fax: 303-398-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number5939
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4000
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2002-00229
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number62523
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: