Provider Demographics
NPI:1588628606
Name:CONSULTANTS IN OBSTETRICS AND GYNECOLOGY
Entity Type:Organization
Organization Name:CONSULTANTS IN OBSTETRICS AND GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-322-2240
Mailing Address - Street 1:4500 E 9TH AVE
Mailing Address - Street 2:# 300
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:303-322-2240
Mailing Address - Fax:303-322-9260
Practice Address - Street 1:4500 E 9TH AVE
Practice Address - Street 2:# 300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-322-2240
Practice Address - Fax:303-322-9260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04008124Medicaid
CO04008124Medicaid