Organization
SOUTHERN COLORADO VASCULAR SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE DONALD MISARE MD (PHYSICIAN)
(719) 630-3465
Entity
Organization
Contact information
Practice address
2960 N CIRCLE DR STE 115, COLORADO SPRINGS, CO 80909-1163
(719) 630-3465
(719) 630-3476
Mailing address
2960 N CIRCLE DR STE 115, COLORADO SPRINGS, CO 80909-1163
(719) 630-3465
(719) 630-3476
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
38531
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36589365
—
CO
Enumeration date
01/18/2007
Last updated
12/04/2009
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