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General NPI Number Information
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NPI Number | 1700071388
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Entity Type | Organization
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Legal Business Name | MARTHA DAMBROSIO MD PC
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 8295 OLD EXCHANGE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-4811
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Country | US
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Telephone | 719-535-8075
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Fax |
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Provider Business Mailing Address
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Address Line | 8295 OLD EXCHANGE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-4811
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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 | OWNER
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Name | MARTHA L DAMBROSIO
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Credential | MD
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Telephone | 719-535-8075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 32478
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License Number State | CO
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