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NPI Profile for POUDRE VALLEY MEDICAL GROUP LLC in PUEBLO, CO.
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Cardiovascular Disease |
207RC0000X | 11 | Physician/Internal Medicine | |
Thoracic Surgery (Cardiothoracic Vascular Surgery) |
208G00000X | 02 | Physician/General Surgery | |
Vascular Surgery |
2086S0129X | 76 | Physician/Peripheral Vascular Disease |
| NPI # | 1710772819 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 04/10/2025 | |
| Last updated | 04/10/2025 - More than a year ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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POUDRE VALLEY MEDICAL GROUP, LLC