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NPI Code Detail

MEDICARE: DARA LYNN KOLODNER M.D.

MEDICARE: DARA LYNN KOLODNER M.D.
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
12084P0800XPsychiatry PhysicianDR.0058245CO

General Provider Information

NPI Number : 1811296817
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARA LYNN KOLODNER M.D.
Provider Business Mailing Address
First Line : 4770 BASELINE RD STE 200
Second Line :
City : BOULDER
State : CO
Zip : 80303-2668
Country : US
Telephone Number : 720-715-8459
Fax Number :
Provider Business Practice Location Address
First Line : 4770 BASELINE RD STE 200
Second Line :
City : BOULDER
State : CO
Zip : 80303-2668
Country : US
Telephone Number : 720-715-8459
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2011
Last Update Date : 07/24/2021

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