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Contact Information

DERMATOLOGY AND ENDOCRINOLOGY LLC
1925 E ORMAN AVE
STE 115
PUEBLO, CO81004-3500
 Phone: 719-564-4500
 Fax: 719-564-0304
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Endocrinology, Diabetes & Metabolism

207RE0101X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for DERMATOLOGY AND ENDOCRINOLOGY LLC · (Female)

NPI # 1114999018
Status Active
Credentials
Entity Individual
Enumeration date 02/03/2006
Last updated 01/11/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • CO License # 26083
  • CO License # 26084
  • CO Medicaid 96378352
  • CO Other 1114999018 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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