NPI 1497728786 · live from the CMS NPI Registry
Kim K Dernovsek, MD
Dermatology in Pueblo, CO. National Provider Identifier 1497728786, active.
NPI record
| NPI | 1497728786 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 1925 E Orman Ave, Ste 115, Pueblo, CO 81004 |
| Practice phone | 719-564-4500 |
| Enumerated | February 8, 2006 |
| Last updated | January 11, 2016 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | 26084 (CO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.