Provider Demographics
NPI:1679852933
Name:CERIANI, PHILIP DOUGLAS (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:DOUGLAS
Last Name:CERIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38638 STUCKER MESA RD
Mailing Address - Street 2:
Mailing Address - City:HOTCHKISS
Mailing Address - State:CO
Mailing Address - Zip Code:81419-6214
Mailing Address - Country:US
Mailing Address - Phone:970-527-7064
Mailing Address - Fax:970-527-7064
Practice Address - Street 1:38638 STUCKER MESA RD
Practice Address - Street 2:
Practice Address - City:HOTCHKISS
Practice Address - State:CO
Practice Address - Zip Code:81419-6214
Practice Address - Country:US
Practice Address - Phone:970-527-7064
Practice Address - Fax:970-527-7064
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO17445207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery