Provider Demographics
NPI:1245409630
Name:CATHERINE D CARRETERO MD PC
Entity Type:Organization
Organization Name:CATHERINE D CARRETERO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARRETERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-331-6744
Mailing Address - Street 1:2150 W 29TH AVE
Mailing Address - Street 2:#600
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3844
Mailing Address - Country:US
Mailing Address - Phone:303-331-6744
Mailing Address - Fax:303-331-6839
Practice Address - Street 1:2150 W 29TH AVE
Practice Address - Street 2:#600
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3844
Practice Address - Country:US
Practice Address - Phone:303-331-6744
Practice Address - Fax:303-331-6839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43374207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty