Provider Demographics
NPI:1558506808
Name:ROCKY MOUNTAIN ENDOCRINOLOGY, P.C.
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN ENDOCRINOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SOWMYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SURYANARAYANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-841-6337
Mailing Address - Street 1:PO BOX 2228
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-1414
Mailing Address - Country:US
Mailing Address - Phone:303-986-9504
Mailing Address - Fax:303-980-8431
Practice Address - Street 1:9235 CROWN CREST BLVD, SUITE 200
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138
Practice Address - Country:US
Practice Address - Phone:303-840-5051
Practice Address - Fax:303-840-5058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43392207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOB4468Medicare PIN