Provider Demographics
NPI:1336363860
Name:SIGURSLID, DAVID ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:SIGURSLID
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 1:18 RIO VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4344
Mailing Address - Country:US
Mailing Address - Phone:970-259-7733
Mailing Address - Fax:
Practice Address - Street 1:755 E 2ND AVE STE E
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5472
Practice Address - Country:US
Practice Address - Phone:970-375-0309
Practice Address - Fax:970-385-1773
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33304207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01333046Medicaid
COBS2367161OtherDEA #
COE84633Medicare UPIN