Individual
MARY E MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10400 E ALAMEDA AVE, DENVER, CO 80247-5104
(303) 360-1553
Mailing address
10400 E ALAMEDA AVE, DENVER, CO 80247-5104
(303) 360-1553
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
38149
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011480
KAISER-COMMERCIAL NUMBER
—
05
—
53558049
—
CO
Enumeration date
02/27/2007
Last updated
11/14/2007
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