Healthcare Provider Details
I. General information
NPI: 1043345382
Provider Name (Legal Business Name): SARAH CARD HUMPHREYS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/23/2007
Last Update Date: 04/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4500 E 9TH AVE STE 740
DENVER CO
80220-3911
US
IV. Provider business mailing address
4500 E 9TH AVE STE 740
DENVER CO
80220-3911
US
V. Phone/Fax
- Phone: 720-941-1778
- Fax: 720-941-1783
- Phone: 720-941-1778
- Fax: 720-941-1783
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 42491 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: