Individual
CHARLES HENRY MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10103 RIDGE GATE PKWY, SUITE 114, LONE TREE, CO 80124
(303) 799-8890
(303) 799-8891
Mailing address
10103 RIDGE GATE PKWY, SUITE 114, LONE TREE, CO 80124
(303) 799-8890
(303) 799-8891
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33478
CO
208000000X
Pediatrics Physician
33478
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89530063
—
CO
Enumeration date
04/06/2006
Last updated
02/08/2010
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