Individual
LEE DAVID ETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
904 S 4TH ST, MONTROSE, CO 81401-4226
(970) 252-2753
(970) 240-7330
Mailing address
PO BOX 792, SHALIMAR, FL 32579-0792
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
DR.0062774
CO
207RP1001X
Pulmonary Disease Physician
ME 0035386
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067872400
—
FL
01
—
110007848
RAILROAD MEDICARE
FL
Enumeration date
11/23/2005
Last updated
12/27/2022
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