Provider Demographics
NPI:1245297555
Name:KORMAN, DAVID S (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:KORMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 E 9TH AVE
Mailing Address - Street 2:500 S
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:303-861-2190
Mailing Address - Fax:303-355-4435
Practice Address - Street 1:4500 E 9TH AVE
Practice Address - Street 2:500 S
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-861-2190
Practice Address - Fax:303-355-4435
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36976207RR0500X
KS0428878207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01369768Medicaid
KS101105Medicare ID - Type Unspecified
CO01369768Medicaid
CO803554Medicare ID - Type Unspecified