Individual
EDWARD JAMES PULIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
39383
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07407246
—
CO
01
—
20329110980033A008
TRICARE WHEATRIDGE
CO
01
—
20329110981201A008
TRICARE SALIDA
CO
Enumeration date
06/15/2006
Last updated
02/03/2015
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