Organization
INNOVATIVE SURGERY AND MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RINA K SHINN MD (PHYSICIAN)
(719) 546-4947
Entity
Organization
Contact information
Practice address
1600 W 24TH ST, PUEBLO, CO 81003-1411
(719) 546-4947
Mailing address
PO BOX 566, PUEBLO, CO 81002-0566
(719) 286-5840
(719) 542-0746
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01358845
—
CO
01
—
DA7417
RR MEDICARE
—
01
—
VI659839
BCBS
—
Enumeration date
04/25/2007
Last updated
01/07/2008
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