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NPI Code Detail

MEDICARE: MARY KRISTEN DEMORUELLE M.D.

MEDICARE: MARY KRISTEN DEMORUELLE 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
1207RR0500XRheumatology Physician48030CO

General Provider Information

NPI Number : 1992900575
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY KRISTEN DEMORUELLE M.D.
Provider Business Mailing Address
First Line : 7111 E LOWRY BLVD STE 200
Second Line :
City : DENVER
State : CO
Zip : 80230-7360
Country : US
Telephone Number : 303-394-2828
Fax Number : 303-320-0242
Provider Business Practice Location Address
First Line : 7111 E LOWRY BLVD STE 200
Second Line :
City : DENVER
State : CO
Zip : 80230-7360
Country : US
Telephone Number : 303-394-2828
Fax Number : 303-320-0242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2007
Last Update Date : 06/08/2026

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