Individual
BRUCE BLYTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1601 E 19TH AVE, SUITE 3750, DENVER, CO 80218-1216
(303) 839-7200
(303) 839-7229
Mailing address
1601 E 19TH AVE, SUITE 3750, DENVER, CO 80218-1216
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
31504
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01315043
—
CO
Enumeration date
04/14/2006
Last updated
07/08/2007
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