Individual
DR. SUSAN GABRIELLE DERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2502 E PIKES PEAK AVE, COLORADO SPRINGS, CO 80909-6033
(719) 365-6840
Mailing address
2695 ROCKY MOUNTAIN AVE, STE 150, LOVELAND, CO 80538-9071
(970) 624-4036
(970) 490-4378
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29573
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01295732
—
CO
Enumeration date
04/02/2007
Last updated
07/28/2016
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