Organization
BOULDER WOMENS CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAKO SHIMODA MD (OWNER)
(303) 441-0587
Entity
Organization
Contact information
Practice address
311 MAPLETON AVE # 100, BOULDER, CO 80304-3979
(303) 441-0587
(303) 996-0801
Mailing address
PO BOX 17458, BOULDER, CO 80308-0458
(303) 441-0587
(303) 996-0801
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
34690
CO
207V00000X
Obstetrics & Gynecology Physician
36257
CO
207V00000X
Obstetrics & Gynecology Physician
Primary
42614
CO
207V00000X
Obstetrics & Gynecology Physician
43546
CO
207V00000X
Obstetrics & Gynecology Physician
56795
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01346907
—
CO
05
—
23028327
—
CO
05
—
55404251
—
CO
05
—
80637779
—
CO
Enumeration date
12/07/2006
Last updated
02/11/2008
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