Healthcare Provider Details

I. General information

NPI: 1588628606
Provider Name (Legal Business Name): CONSULTANTS IN OBSTETRICS AND GYNECOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E 9TH AVE # 300
DENVER CO
80220
US

IV. Provider business mailing address

4500 E 9TH AVE # 300
DENVER CO
80220
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-2240
  • Fax: 303-322-9260
Mailing address:
  • Phone: 303-322-2240
  • Fax: 303-322-9260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SUSAN MOISON
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 303-322-2240