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Individual

LISA FORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
40387
CO
207RT0003X
Transplant Hepatology Physician
Primary
DR.0040387
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18522831
CO
Enumeration date
10/13/2006
Last updated
11/19/2018
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