MEDICARE: RACHAEL NEMCIC 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
1	208600000X	Surgery Physician	16016	NV
2	208600000X	Surgery Physician	DR.0063060	CO

General Provider Information

NPI Number	:	1316266703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL NEMCIC MD

Provider Business Mailing Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 150
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9071
Country	:	US
Telephone Number	:	706-242-4049
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 E HARMONY RD UNIT 330
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-3403
Country	:	US
Telephone Number	:	970-221-5878
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2010
Last Update Date	:	08/12/2019

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