Individual
SHANDA MARIEL GOMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
555 PROSPECT AVE, ESTES PARK, CO 80517-6312
(303) 333-4069
Mailing address
1058 JACKSON ST, DENVER, CO 80206-3524
(303) 333-4069
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0052647
CO
207P00000X
Emergency Medicine Physician
Primary
A115657
CA
Other
Enumeration date
01/10/2011
Last updated
10/02/2013
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