Organization
MOUNTAIN BLUE CANCER CARE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMIR E WITTA MD (OWNER)
(303) 999-6745
Entity
Organization
Contact information
Practice address
3501 S CORONA ST STE 1, ENGLEWOOD, CO 80113-3907
(303) 999-6745
(303) 586-2228
Mailing address
3501 S CORONA ST STE 1, ENGLEWOOD, CO 80113-3907
(303) 999-6745
(303) 586-2228
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
39764
CO
207RH0003X
Hematology & Oncology Physician
CO39762
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82076529
—
CO
Enumeration date
10/01/2009
Last updated
02/18/2025
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