Provider Demographics
NPI:1225066111
Name:DONATI, THERESA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:ANN
Last Name:DONATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:THERESA
Other - Middle Name:AV
Other - Last Name:DONATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1707 COLE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3220
Mailing Address - Country:US
Mailing Address - Phone:303-716-8013
Mailing Address - Fax:303-763-5495
Practice Address - Street 1:30940 STAGECOACH BLVD
Practice Address - Street 2:STE 270E
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7984
Practice Address - Country:US
Practice Address - Phone:303-674-6062
Practice Address - Fax:303-670-0776
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO50045207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine