Provider Demographics
NPI:1033382981
Name:HUBBELL, SARAH BROOM (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BROOM
Last Name:HUBBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:ANNIS
Other - Last Name:BROOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1375 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1114
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49763207R00000X
CODR.0049763208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO021562OtherKAISER COMMERCIAL NUMBER
CO05227062Medicaid
CO05227062Medicaid