Provider Demographics
NPI:1891098877
Name:NORM NUMEROF, MD, PC
Entity Type:Organization
Organization Name:NORM NUMEROF, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORM
Authorized Official - Middle Name:
Authorized Official - Last Name:NUMEROF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-949-5434
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 PL.
Practice Address - Street 2:SUITE 112
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620-0000
Practice Address - Country:US
Practice Address - Phone:970-949-5434
Practice Address - Fax:970-949-0376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO 30580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC6676-1OtherPTAN
CO1720192776OtherNPI