NPI Profile for POUDRE VALLEY MEDICAL GROUP LLC in COLORADO SPRINGS, CO.
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Infectious Disease |
207RI0200X | 11 | Physician/Internal Medicine | |
Wound Care |
163WW0000X |
| NPI # | 1932793635 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/23/2021 | |
| Last updated | 08/19/2024 - 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
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