Provider Demographics
NPI:1548236714
Name:COIRO, SUSANNA (MD)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:
Last Name:COIRO
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 1:2525 S DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5817
Mailing Address - Country:US
Mailing Address - Phone:303-715-7184
Mailing Address - Fax:
Practice Address - Street 1:2525 S DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5817
Practice Address - Country:US
Practice Address - Phone:303-629-2100
Practice Address - Fax:303-629-2110
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0035299208M00000X
CO35299207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM86429761Medicaid
UTZ3329Medicaid
CO71687858Medicaid
KS200402450AMedicaid
UTZ3329Medicaid
KS200402450AMedicaid