Healthcare Provider Details

I. General information

NPI: 1104275684
Provider Name (Legal Business Name): YURI KRAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YURI ENDO M.D.

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 JACKSON ST
DENVER CO
80206-2762
US

IV. Provider business mailing address

1400 JACKSON ST # K830
DENVER CO
80206-2762
US

V. Phone/Fax

Practice location:
  • Phone: 877-225-5654
  • Fax:
Mailing address:
  • Phone: 303-398-1245
  • Fax: 303-270-2201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMSDR.0000006
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: