SHANNON DETTY, M.D.
Dermatology
Active
Individual
NPI: 1790149763
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dermatology | 207N00000X | Yes | 70147 (WI) |
Frequently Asked Questions
NPI 1790149763 is the National Provider Identifier for SHANNON DETTY, M.D., a Dermatology provider located in Boulder, CO. This NPI was enumerated on April 6, 2016.
SHANNON DETTY, M.D. practices at 2880 FOLSOM ST STE 200, Boulder, CO 80304.
Quick Facts
- NPI
- 1790149763
- Type
- Individual
- Enumerated
- Apr 6, 2016
- Last Updated
- Oct 7, 2022
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