Individual
DR. TAKE GEORGE PULLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5201 YELLOWSTONE RD, CHEYENNE, WY 82009-4741
(307) 632-1114
(307) 632-9920
Mailing address
PO BOX 20970, CHEYENNE, WY 82003-7020
(307) 632-1114
(307) 632-9920
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A73020
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100097800
—
WY
05
—
1831284900
—
WY
Enumeration date
10/04/2006
Last updated
10/28/2022
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