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NPI Code Detail

MEDICARE: MR. GREGORY J. ENGELKEN PA-C

MEDICARE: MR. GREGORY J. ENGELKEN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant1150CO
2363A00000XPhysician AssistantPA.0001150CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083746986
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GREGORY J. ENGELKEN PA-C
Provider Business Mailing Address
First Line : 950 E HARVARD AVE STE 550
Second Line :
City : DENVER
State : CO
Zip : 80210-7000
Country : US
Telephone Number : 303-778-6527
Fax Number : 303-733-1288
Provider Business Practice Location Address
First Line : 950 E HARVARD AVE STE 550
Second Line :
City : DENVER
State : CO
Zip : 80210-7000
Country : US
Telephone Number : 303-778-6527
Fax Number : 303-733-1288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 01/25/2022

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