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General NPI Number Information
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NPI Number | 1457398075
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Entity Type | Individual
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Provider Name | CAROLYN RUTH BURKHARDT MD
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Gender | Female
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 09/08/2011
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Provider Practice Location Address
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Address Line | 5200 DTC PKWY #280
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2709
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Country | US
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Telephone | 720-200-5454
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Fax | 720-200-5460
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Provider Business Mailing Address
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Address Line | 5200 DTC PKWY #280
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2709
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Country | US
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Telephone | 720-200-5454
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Fax | 720-200-5460
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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 | 28021
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License Number State | CO
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