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General NPI Number Information
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NPI Number | 1477015063
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Entity Type | Individual
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Provider Name | SARA ENID TISHERMAN MD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 8959 E 40TH AVE
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City | DENVER
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State | CO
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Zip | 80238-5026
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Country | US
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Telephone | 720-462-2263
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Fax | 303-845-9656
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Provider Business Mailing Address
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Address Line | PO BOX 110429
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City | AURORA
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State | CO
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Zip | 80042-0429
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD478338
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.148505
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0075904
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License Number State | CO
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