Provider Demographics
NPI:1952345118
Name:STARKE, DOUGLAS HOWARD (PA-C)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:HOWARD
Last Name:STARKE
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1390 S POTOMAC ST
Mailing Address - Street 2:STE 120
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-6165
Mailing Address - Country:US
Mailing Address - Phone:303-695-1313
Mailing Address - Fax:303-695-5121
Practice Address - Street 1:1390 S POTOMAC ST
Practice Address - Street 2:STE 120
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-6165
Practice Address - Country:US
Practice Address - Phone:303-695-1313
Practice Address - Fax:303-695-5121
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2016-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO388363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
COR98233Medicare UPIN
COCA1808Medicare ID - Type Unspecified