Healthcare Provider Details

I. General information

NPI: 1184120040
Provider Name (Legal Business Name): MIRIAM LAQUER ESTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2018
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N HIGH ST STE 230
DENVER CO
80205-5507
US

IV. Provider business mailing address

2055 N HIGH ST STE 230
DENVER CO
80205-5507
US

V. Phone/Fax

Practice location:
  • Phone: 303-860-9990
  • Fax:
Mailing address:
  • Phone: 303-860-9990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number0075228
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: