Individual
DR. TERRY SHIRA SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11600 W 2ND PL, LAKEWOOD, CO 80228-1527
(719) 537-0712
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
36121
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013621211
—
CO
01
—
028998
KAISER COMMERCIAL NUMBER
CO
Enumeration date
06/03/2006
Last updated
06/22/2021
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