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NPI Code Detail

MEDICARE: ROBERT CARL ENGUIDANOS M.D.

MEDICARE: ROBERT CARL ENGUIDANOS M.D.
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
1207R00000XInternal Medicine PhysicianDR.0054760CO
2208M00000XHospitalist PhysicianDR.0054760CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01430249OTHERCORR 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
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518952811
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT CARL ENGUIDANOS M.D.
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 :
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 :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 11/01/2019

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Directions to “ ROBERT CARL ENGUIDANOS M.D.” Practice Location

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