Individual
LIRIO S POLINTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 N GRAND, SUITE 150, PUEBLO, CO 81003-2749
(719) 595-7680
(719) 595-7687
Mailing address
PO BOX 560825, DENVER, CO 80256-0825
(719) 595-7580
(719) 545-0176
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
24270
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01242700
—
CO
01
—
COA103944
PTAN
—
Enumeration date
04/26/2006
Last updated
03/13/2017
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