Healthcare Provider Details

I. General information

NPI: 1114182052
Provider Name (Legal Business Name): RUTA OBERGFELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E BOULDER ST
COLORADO SPRINGS CO
80909-5533
US

IV. Provider business mailing address

DEPT 1029
DENVER CO
80263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 800-237-6723
  • Fax: 352-732-6282
Mailing address:
  • Phone: 800-237-6723
  • Fax: 352-732-6282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number46678
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: