Provider Demographics
NPI:1417992603
Name:GEROW, KELLY RENAE (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:RENAE
Last Name:GEROW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 S POTOMAC ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4508
Mailing Address - Country:US
Mailing Address - Phone:303-752-3000
Mailing Address - Fax:303-752-3003
Practice Address - Street 1:1444 S POTOMAC ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4508
Practice Address - Country:US
Practice Address - Phone:303-752-3000
Practice Address - Fax:303-752-3003
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO31312207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF65475Medicare UPIN
CO33741Medicare ID - Type Unspecified