NPI 1053449306 · live from the CMS NPI Registry
Dermatology Specialists Of Boulder, PC
Dermatology, MOHS-Micrographic Surgery in Louisville, CO. National Provider Identifier 1053449306, active.
NPI record
| NPI | 1053449306 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology, MOHS-Micrographic Surgery 207ND0101X |
| Practice location | 1056 S 88th St, Louisville, CO 80027 |
| Practice phone | 303-442-6647 |
| Enumerated | March 1, 2007 |
| Last updated | November 14, 2024 |
| Authorized official | Shawn Allen, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | 43816 (CO) |
| Dermatology, MOHS-Micrographic Surgery primary | 207ND0101X | — |
| Dermatology, Dermatopathology | 207ND0900X | 43816 (CO) |
| Dermatology, Procedural Dermatology | 207NS0135X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.