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General NPI Number Information
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NPI Number | 1790703239
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Entity Type | Organization
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Legal Business Name | MOUNTAIN RHEUMATOLOGY LLC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 4500 E 9TH AVE NO 500 S
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City | DENVER
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State | CO
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Zip | 80220-3900
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Country | US
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Telephone | 303-861-2190
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Fax | 303-355-4435
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Provider Business Mailing Address
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Address Line | 4500 E 9TH AVE NO 500 S
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City | DENVER
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State | CO
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Zip | 80220-3900
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Country | US
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Telephone | 303-861-2190
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Fax | 303-355-4435
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID KORMAN
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Credential | MD
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Telephone | 303-861-2190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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