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General NPI Number Information
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NPI Number | 1821134644
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Entity Type | Individual
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Provider Name | ADAM COURCHAINE PA-C
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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 | 07/14/2021
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Provider Practice Location Address
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Address Line | 7200 E DRY CREEK RD STE G101
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City | CENTENNIAL
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State | CO
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Zip | 80112-2574
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Country | US
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Telephone | 720-647-7460
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Fax | 720-684-5766
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Provider Business Mailing Address
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Address Line | 600 W COUNTY LINE RD APT 31-202
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-6512
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Country | US
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Telephone | 774-219-9311
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 4256
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | AP2155
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License Number State | MA
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