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NPI Code Detail

MEDICARE: SYDNEY CELESTE DITTMAN

MEDICARE: SYDNEY CELESTE DITTMAN
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
1207Q00000XFamily Medicine PhysicianDR.0061080CO
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1619400918
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY CELESTE DITTMAN
Provider Business Mailing Address
First Line : 5351 S ROSLYN ST STE 200
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-2132
Country : US
Telephone Number : 303-770-6500
Fax Number : 303-770-2211
Provider Business Practice Location Address
First Line : 5351 S ROSLYN ST STE 200
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-2132
Country : US
Telephone Number : 303-770-6500
Fax Number : 303-770-2211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2017
Last Update Date : 06/13/2024

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Directions to “ SYDNEY CELESTE DITTMAN ” Practice Location

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