Individual
JAMIE SUROVIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12645 E EUCLID DR, CENTENNIAL, CO 80111-6437
(303) 493-1910
(303) 493-1915
Mailing address
12645 E EUCLID DR, CENTENNIAL, CO 80111-6437
(303) 493-1910
(303) 493-1915
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
48670
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48670
STATE MEDICAL LICENSE
CO
05
—
68171315
—
CO
Enumeration date
04/21/2010
Last updated
12/09/2020
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