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NPI Code Detail

MEDICARE: SILVER MOUNTAIN PEDIATRICS, INC.

MEDICARE: SILVER MOUNTAIN PEDIATRICS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134008337
Entity Type Code : Organization
Provider Name (Legal Business Name) : SILVER MOUNTAIN PEDIATRICS, INC.
Provider Business Mailing Address
First Line : 2530 COLORADO AVE UNIT 2A
Second Line :
City : DURANGO
State : CO
Zip : 81301-4761
Country : US
Telephone Number : 970-512-5255
Fax Number : 970-615-4981
Provider Business Practice Location Address
First Line : 2530 COLORADO AVE UNIT 2A
Second Line :
City : DURANGO
State : CO
Zip : 81301-4761
Country : US
Telephone Number : 970-512-5255
Fax Number : 970-615-4981
Authorized Official
Title or Position : CO-OWNER
Name : LAUREN LAQUA
Credential : NP
Telephone Number : 662-298-6191
Provider Enumeration Date : 09/01/2025
Last Update Date : 03/20/2026

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Directions to “SILVER MOUNTAIN PEDIATRICS, INC. ” Practice Location

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