Healthcare Provider Details

I. General information

NPI: 1508252958
Provider Name (Legal Business Name): SARAH CORTEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2373 G RD STE 240
GRAND JUNCTION CO
81505-1006
US

IV. Provider business mailing address

4961 LACLEDE AVE APT 512
SAINT LOUIS MO
63108-1457
US

V. Phone/Fax

Practice location:
  • Phone: 970-243-7908
  • Fax: 970-245-0656
Mailing address:
  • Phone: 248-701-2713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0062361
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: