Individual
TODD WINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
46617
CO
207YP0228X
Pediatric Otolaryngology Physician
Primary
DR.0046617
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61729060
—
CO
Enumeration date
04/25/2007
Last updated
11/29/2018
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