Individual
DR. DIANE LUCY KALLGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3434 47TH ST, #200, BOULDER, CO 80301-1880
(303) 444-8100
(303) 444-8113
Mailing address
3434 47TH ST, #200, BOULDER, CO 80301-1880
(303) 444-8100
(303) 444-8113
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
33197
CO
207N00000X
Dermatology Physician
Primary
33197
CO
207ND0900X
Dermatopathology Physician
33197
CO
Other
Enumeration date
09/07/2005
Last updated
08/27/2007
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