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Contact Information

BOULDER GYNECOLOGY & MINIMALLY INVASIVE SURGERY
4800 RIVERBEND RD
SUITE 200
BOULDER, CO80301-2636
 Phone: 720-382-2621
 Fax: 720-382-2625
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for BOULDER GYNECOLOGY MINIMALLY INVASIVE SURGERY · (Female)

NPI Number 1194071605
Status Active
Credentials
Entity Individual
Enumeration date 08/02/2012
Last updated 08/02/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • CO License # 43874
  • CO Medicaid 48574279
  • CO Other 802492 MEDICARE ID - TYPE UNSPECIFIED
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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