Healthcare Provider Details

I. General information

NPI: 1194891176
Provider Name (Legal Business Name): GENEVIEVE MARI SYED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 TANGLEWOOD DRIVE
SILVERTHORNE CO
80498
US

IV. Provider business mailing address

P.O. BOX 911416
DENVER CO
80291-1416
US

V. Phone/Fax

Practice location:
  • Phone: 970-468-1003
  • Fax: 970-262-2196
Mailing address:
  • Phone: 970-468-1003
  • Fax: 970-262-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR42884
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: