Provider Demographics
NPI:1225728900
Name:SYLVESTER, DONALD
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:SYLVESTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5708 S MALTA ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3316
Mailing Address - Country:US
Mailing Address - Phone:303-587-6827
Mailing Address - Fax:
Practice Address - Street 1:5708 S MALTA ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3316
Practice Address - Country:US
Practice Address - Phone:303-587-6827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service