Provider Demographics
NPI:1952582637
Name:BOYLE, SHEILA ROSE
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ROSE
Last Name:BOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 HARLAN ST
Mailing Address - Street 2:STE 155
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-2924
Mailing Address - Country:US
Mailing Address - Phone:303-426-5000
Mailing Address - Fax:
Practice Address - Street 1:9101 HARLAN ST
Practice Address - Street 2:STE 155
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-2924
Practice Address - Country:US
Practice Address - Phone:303-426-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37980207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG32429Medicare UPIN
CO506118Medicare PIN