MEDICARE: NATHANIEL M PASCUAL, PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
3	207RP1001X	Pulmonary Disease Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	COAAA0692	OTHER	CO	MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1093004434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATHANIEL M PASCUAL, PC

Provider Business Mailing Address
First Line	:	PO BOX 64080
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80962-4080
Country	:	US
Telephone Number	:	719-445-9167
Fax Number	:	888-900-1252

Provider Business Practice Location Address
First Line	:	8540 SCARBOROUGH DR STE 370
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-7519
Country	:	US
Telephone Number	:	719-445-9167
Fax Number	:	888-900-1252

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NATHANIEL PASCUAL
Credential	:	MD
Telephone Number	:	719-445-9167

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	01/03/2012

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