Provider Demographics
NPI:1639328321
Name:GERALD CHITTERS MD PLLC
Entity Type:Organization
Organization Name:GERALD CHITTERS MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHITTERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-545-5380
Mailing Address - Street 1:954 NORTH ST STE 302
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3307
Mailing Address - Country:US
Mailing Address - Phone:303-545-5380
Mailing Address - Fax:303-402-0445
Practice Address - Street 1:954 NORTH ST STE 302
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3307
Practice Address - Country:US
Practice Address - Phone:303-545-5380
Practice Address - Fax:303-402-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty