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Individual

DAVID POTTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
41 MONTEBELLO RD STE 116, PUEBLO, CO 81001-1366
(719) 545-2746
(719) 542-9638
Mailing address
41 MONTEBELLO RD STE 116, PUEBLO, CO 81001-1366
(719) 545-2746
(719) 542-9638

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
41306
CO
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
41306
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
44935528
CO
01
P00031286
RAILROAD MEDICARE
05
T1106
UT
Enumeration date
03/27/2006
Last updated
04/16/2018
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