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General NPI Number Information
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NPI Number | 1528459815
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Entity Type | Individual
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Provider Name | POWELL PERNG MD
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Gender | Male
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 1375 E 20TH AVE
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City | DENVER
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State | CO
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Zip | 80205-5422
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Country | US
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Telephone | 303-338-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 10350 E DAKOTA AVE
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City | DENVER
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State | CO
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Zip | 80247-1314
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 12192581-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | DR.0067923
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License Number State | CO
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