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General NPI Number Information
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NPI Number | 1376753723
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Entity Type | Organization
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Legal Business Name | COLORADO GYN CONSULTANTS, P.C.
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 04/26/2011
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Provider Practice Location Address
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Address Line | 1800 15TH ST STE 220
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City | GREELEY
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State | CO
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Zip | 80631-4500
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Country | US
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Telephone | 970-353-1335
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Fax | 970-353-7376
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Provider Business Mailing Address
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Address Line | 1800 15TH ST STE 220
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City | GREELEY
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State | CO
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Zip | 80631-4500
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Country | US
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Telephone | 970-353-1335
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Fax | 970-353-7376
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN D CARTER
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Credential | M.D.
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Telephone | 970-353-1335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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