Provider Demographics
NPI:1861552739
Name:DUTMERS, BARBARA (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:DUTMERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 E ORCHARD ROAD
Mailing Address - Street 2:SUITE 120 SO
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-721-0905
Mailing Address - Fax:303-721-8820
Practice Address - Street 1:7600 E ORCHARD ROAD
Practice Address - Street 2:SUITE 120 SO
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-721-0905
Practice Address - Fax:303-721-8820
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO272462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO611289100OtherUS DEPT OF LABOR
CO203928745OtherKAISER
CO203928745OtherKAISER
COC27261Medicare ID - Type Unspecified