Provider Demographics
NPI:1447342043
Name:STAAR-KUMOSA, ALDONA W (MD)
Entity type:Individual
Prefix:MRS
First Name:ALDONA
Middle Name:W
Last Name:STAAR-KUMOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9397 CROWN CREST BLVD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8789
Mailing Address - Country:US
Mailing Address - Phone:303-770-0500
Mailing Address - Fax:303-220-5053
Practice Address - Street 1:9397 CROWN CREST BLVD
Practice Address - Street 2:SUITE 420
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8789
Practice Address - Country:US
Practice Address - Phone:303-770-0500
Practice Address - Fax:303-220-5053
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO37220207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO80676341Medicaid
83027Medicare ID - Type Unspecified
CO80676341Medicaid