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General NPI Number Information
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NPI Number | 1295378628
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Entity Type | Organization
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Legal Business Name | PREMIER SURGEONS PC
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Dates
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Enumeration Date | 10/17/2019
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 7780 S BROADWAY STE 250
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City | LITTLETON
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State | CO
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Zip | 80122-2633
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Country | US
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Telephone | 303-795-3375
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Fax | 303-795-0621
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Provider Business Mailing Address
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Address Line | 7780 S BROADWAY STE 250
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City | LITTLETON
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State | CO
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Zip | 80122-2633
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Country | US
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Telephone | 303-795-3375
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Fax | 303-795-0621
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Authorized Official
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Title or Position | OWNER
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Name | CREA L FUSCO
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Credential | MD
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Telephone | 773-718-4631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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