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General NPI Number Information
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NPI Number | 1982660817
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Entity Type | Organization
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Legal Business Name | LAURA K. POMERENKE, MD, PC
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 3030 N CIRCLE DR SUITE 216
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1177
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Country | US
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Telephone | 719-471-3930
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Fax | 719-471-3543
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Provider Business Mailing Address
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Address Line | 3030 N CIRCLE DR SUITE 216
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1177
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Country | US
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Telephone | 719-471-3930
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Fax | 719-471-3543
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAURA KAY POMERENKE
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Credential | M.D.
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Telephone | 719-471-3930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 34528
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License Number State | CO
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