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General NPI Number Information
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NPI Number | 1326198169
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Entity Type | Individual
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Provider Name | SUSAN PATRICIA DIAS MD
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 1601 E 19TH AVENUE SUITE # 3650
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City | DENVER
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State | CO
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Zip | 80218
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Country | US
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Telephone | 303-831-4774
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Fax | 303-839-7750
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Provider Business Mailing Address
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Address Line | 23 JERSEY STREET
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City | DENVER
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State | CO
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Zip | 80220
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Country | US
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Telephone | 303-331-0539
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35677
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License Number State | CO
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