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General NPI Number Information
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NPI Number | 1972800787
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Entity Type | Organization
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Legal Business Name | DORIS C GUNDERSEN M D P C
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Dates
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Enumeration Date | 02/15/2011
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 425 S CHERRY ST SUITE 810
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City | DENVER
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State | CO
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Zip | 80246-1226
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Country | US
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Telephone | 303-717-8516
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Fax | 303-738-0644
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Provider Business Mailing Address
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Address Line | 425 S CHERRY ST SUITE 810
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City | DENVER
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State | CO
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Zip | 80246-1226
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Country | US
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Telephone | 303-717-8516
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Fax | 303-738-0644
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Authorized Official
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Title or Position | OWNER
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Name | DORIS CHRISTINE GUNDERSEN
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Credential | M.D.
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Telephone | 303-717-8516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 30452
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License Number State | CO
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