NPI 1063018000 · live from the CMS NPI Registry
Boulder Valley Center For Dermatology LLC
Dermatology in Boulder, CO. National Provider Identifier 1063018000, active.
NPI record
| NPI | 1063018000 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 3000 Center Green Dr Ste 260, Boulder, CO 80301 |
| Practice phone | 303-604-1444 |
| Mailing address | Po Box 272308, Fort Collins, CO 80527 |
| Enumerated | December 7, 2020 |
| Last updated | May 13, 2024 |
| Authorized official | Sadie Nealy, Assistant Billing Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.