Individual
CODY WAYNE MCILVAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 BANNOCK ST # MC0108, DENVER, CO 80204-4597
(303) 602-5176
Mailing address
777 BANNOCK ST # MC0108, DENVER, CO 80204-4597
(303) 602-5176
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0070796
CO
207P00000X
Emergency Medicine Physician
TL.7874
WY
Other
Enumeration date
03/29/2020
Last updated
03/20/2024
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