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NPI 1578609590

NPI 1578609590 : KURT ALLAN SONNENBERG M.D. : GLENWOOD SPRINGS, CO

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General NPI Number Information
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    NPI Number           |    1578609590
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    Entity Type          |    Individual 
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    Provider Name        |    KURT ALLAN SONNENBERG M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/29/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1310 BENNETT AVE 
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    City                 |    GLENWOOD SPRINGS
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    State                |    CO
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    Zip                  |    81601-3914
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    Country              |    US
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    Telephone            |    970-945-0385
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1310 BENNETT AVE 
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    City                 |    GLENWOOD SPRINGS
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    State                |    CO
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    Zip                  |    81601-3914
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    Country              |    US
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    Telephone            |    970-945-0385
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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        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    31469
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    License Number State |    CO
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