Provider Demographics
NPI:1568643708
Name:POMERENKE, LAURA KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:KAY
Last Name:POMERENKE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8702
Mailing Address - Country:US
Mailing Address - Phone:970-624-4443
Mailing Address - Fax:970-490-4175
Practice Address - Street 1:175 S UNION BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3113
Practice Address - Country:US
Practice Address - Phone:719-477-0211
Practice Address - Fax:719-364-2570
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2015-01-26
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Provider Licenses
StateLicense IDTaxonomies
CO34528208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01345289Medicaid
CO271453YLB8Medicare PIN
CO01345289Medicaid
COF49418Medicare UPIN