Search › Colorado › 207N00000X
Shannon Detty, M.D
NPI 1790149763 · on the registry since 2016
Practice
- Address
- 2880 Folsom St Ste 200
Boulder, CO 80304 - Phone
- (303) 442-6647
- Fax
- (303) 442-2696
- Organisation at this address
- Everside Health, Llc
Marathon Health, Llc
Goose Creek Pharmacy
Kingston Dialysis Llc
Boulder Internal Medicine PcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 8
Additional practice sites
- 1056 S 88th St, Louisville, CO
Registry record
- Primary taxonomy
- 207N00000X
207N00000X
- Also registered as
- 207N00000X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-10-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Colorado