MEDICARE: WINSTON SAUBER 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
1	363A00000X	Physician Assistant	0004790	CO
2	363A00000X	Physician Assistant
3	363A00000X	Physician Assistant	PA.0004790	CO

General Provider Information

NPI Number	:	1942758917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WINSTON SAUBER PA-C

Provider Business Mailing Address
First Line	:	3650 N ADAMS ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-3730
Country	:	US
Telephone Number	:	609-802-3732
Fax Number	:	303-284-2221

Provider Business Practice Location Address
First Line	:	8200 E BELLEVIEW AVE STE 230C
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-2824
Country	:	US
Telephone Number	:	720-259-8550
Fax Number	:	303-284-2221

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

Provider Enumeration Date	:	09/19/2016
Last Update Date	:	09/22/2020

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Directions to “ WINSTON SAUBER PA-C” Practice Location

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