Individual
CAROLYN S IM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3501 S CLARKSON ST, ENGLEWOOD, CO 80113-3916
(303) 783-8844
(303) 783-2002
Mailing address
3501 S CLARKSON ST, ENGLEWOOD, CO 80113-3916
(303) 783-8844
(303) 783-2002
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0006728
CO
363AM0700X
Medical Physician Assistant
PA.0006728
CO
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096114
—
WI
Enumeration date
07/19/2019
Last updated
03/20/2024
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