Provider Demographics
NPI:1720192776
Name:NUMEROF, NORMAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:DAVID
Last Name:NUMEROF
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:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81658-0326
Mailing Address - Country:US
Mailing Address - Phone:970-949-5434
Mailing Address - Fax:970-949-0376
Practice Address - Street 1:142 BEAVER CREEK PLACE
Practice Address - Street 2:SUITE 112
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620
Practice Address - Country:US
Practice Address - Phone:970-949-5434
Practice Address - Fax:970-949-0376
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COB34512Medicare UPIN
COC66761Medicare PIN