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NPI Code Detail

MEDICARE: VICTORIA ANNE CLIPSHAM MD

MEDICARE:   VICTORIA ANNE CLIPSHAM  MD
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
1208M00000XHospitalist Physician45131CO
2207R00000XInternal Medicine Physician45131CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00472222OTHERCORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164408811
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA ANNE CLIPSHAM MD
Provider Business Mailing Address
First Line : 2637 MIDPOINT DR STE B
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-4408
Country : US
Telephone Number : 970-488-1666
Fax Number : 970-472-9381
Provider Business Practice Location Address
First Line : 2637 MIDPOINT DR STE B
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-4408
Country : US
Telephone Number : 970-488-1666
Fax Number : 970-472-9381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 11/01/2019

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Directions to “ VICTORIA ANNE CLIPSHAM MD” Practice Location

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