Organization
BOULDER GYNECOLOGY & MINIMALLY INVASIVE SURGERY
Active
Other names
Boulder Gynecology
Organization subpart
No
Provider details
NPI number
Authorized official
LISA LEPINE M.D. (PRESIDENT/OWNER)
(720) 382-2621
Entity
Organization
Contact information
Practice address
4800 RIVERBEND RD, SUITE 200, BOULDER, CO 80301-2636
(720) 382-2621
(720) 382-2625
Mailing address
4800 RIVERBEND RD, SUITE 200, BOULDER, CO 80301-2636
(720) 382-2621
(720) 382-2625
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
43874
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48574279
—
CO
01
—
802492
MEDICARE ID - TYPE UNSPECIFIED
CO
Enumeration date
08/02/2012
Last updated
08/02/2012
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