Provider Demographics
NPI:1417956343
Name:ZURAFF-PERRYMAN, LISA ANN (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:ZURAFF-PERRYMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:PERRYMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10940 S PARKER RD
Mailing Address - Street 2:NO 805
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7440
Mailing Address - Country:US
Mailing Address - Phone:303-805-4470
Mailing Address - Fax:303-840-0551
Practice Address - Street 1:9397 CROWN CREST BLVD
Practice Address - Street 2:STE 301
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8575
Practice Address - Country:US
Practice Address - Phone:303-840-8822
Practice Address - Fax:303-840-8824
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR-37199208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO40080Medicare PIN
COCOB4076Medicare PIN
UTH67207Medicare UPIN