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Organization

MOUNTAINLAND PEDIATRICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN E SPOERKE MD (PRESIDENT/CEO)
(303) 430-0823
Entity
Organization

Contact information

Practice address
8889 FOX DRIVE, SUITE A, DENVER, CO 80260-8842
(303) 430-0823
(303) 426-9581
Mailing address
8889 FOX DRIVE, SUITE A, DENVER, CO 80260-8842
(303) 430-0823
(303) 426-9581

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04008363
CO
01
0600672594
CLIA
CO
Enumeration date
10/19/2006
Last updated
08/22/2020
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