Individual
DR. KATHLEEN A DAETWYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10240 PARK MEADOWS DR, LONE TREE, CO 80124-5425
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0054867
CO
207L00000X
Anesthesiology Physician
BC5174494-374
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026021
KAISER COMMERCIAL NUMBER
CO
05
—
70053235
—
CO
Enumeration date
08/28/2009
Last updated
04/26/2021
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