NPI 1417001868 · Physician · Anthem
Strong multi-source corroboration of active practice across 8 carrier networks with confirmed Colorado DORA license.
NPPES
BOULDER, 80302
Freshness: Unknown
Network Status
Listed with 9 carriers
DORA License
Active
Medicare
Non-Medicare specialty
Care Compare
No Care Compare data
PECOS Enrollment
No PECOS data
Active NPI with specialty classification
Active Colorado DORA license confirmed
No Medicare billing · No electronic endpoint · No PECOS enrollment
Single address source (NPPES)
Listed in multiple carrier networks
8 networks across 3 carriers
Strong network presence across 8 carrier networks with corroborating federal activity signals.
Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.