Provider Demographics
NPI:1881955920
Name:URISH, ABIGAIL RUTH (MD)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:RUTH
Last Name:URISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:303-338-3339
Mailing Address - Fax:
Practice Address - Street 1:215 S PARKSIDE DR STE 215
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3131
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0055102207Q00000X
MI4301100841207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27259340Medicaid
CO029233OtherKAISER COMMERCIAL NUMBER