Organization
PORTERCARE ADVENTIST HEALTH SYSTEM
Active
Other names
South Suburban Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA SKINNER (OMA ADMINISTRATOR)
(303) 673-7175
Entity
Organization
Contact information
Practice address
7750 S BROADWAY STE 100, LITTLETON, CO 80122-2630
(303) 347-9897
(303) 347-9912
Mailing address
PO BOX 911244, DENVER, CO 80291-1244
(303) 643-1099
(303) 643-1176
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15600289
—
CO
Enumeration date
07/30/2009
Last updated
07/21/2022
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