Provider Demographics
NPI:1528013000
Name:SHIRAR, LORA ELANE (MD)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:ELANE
Last Name:SHIRAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:L
Other - Middle Name:ELANE
Other - Last Name:SHIRAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5920 MCINTYRE ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-7445
Mailing Address - Country:US
Mailing Address - Phone:303-949-1250
Mailing Address - Fax:
Practice Address - Street 1:5920 MCINTYRE ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-7445
Practice Address - Country:US
Practice Address - Phone:303-949-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10013207Q00000X
MN108606207Q00000X
CO33226207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01332261Medicaid
COC080183782OtherRAILROAD MEDICARE
COC304127Medicaid
COC373888Medicaid
COC524308Medicaid
COP00012544OtherRAILROAD MEDICARE
ID806323000Medicaid
COP00071247OtherRAILROAD MEDICARE
COC396338Medicaid
COC488148Medicaid
COC080182858OtherRAILROAD MEDICARE
COC488148Medicare PIN
COC488148Medicaid
COC373888Medicaid
COC304127Medicaid
MT000082541Medicare PIN
COP00012544OtherRAILROAD MEDICARE
COF99849Medicare UPIN