Provider Demographics
NPI:1770639452
Name:SORENSEN, LIEF (MD)
Entity Type:Individual
Prefix:
First Name:LIEF
Middle Name:
Last Name:SORENSEN
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 1:80 HEALTH PARK DR
Mailing Address - Street 2:SUITE 50
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9584
Mailing Address - Country:US
Mailing Address - Phone:303-661-4100
Mailing Address - Fax:
Practice Address - Street 1:80 HEALTH PARK DR
Practice Address - Street 2:SUITE 50
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-9584
Practice Address - Country:US
Practice Address - Phone:303-661-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46813207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology