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 |
| LBN Legal business name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Authorized official | JANA CONROY - (DIRECTOR OF CREDENTIALING) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 02/23/2021 |
| Last updated | 08/19/2024 - More than a year ago |
| Identifiers | n/a |
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