Individual
EVAN LYNELL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 689-4000
Mailing address
3501 QUIVAS ST, DENVER, CO 80211-3053
(719) 321-5027
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301097200
MI
207P00000X
Emergency Medicine Physician
Primary
DR0052131
CO
Other
Enumeration date
07/08/2010
Last updated
06/17/2013
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