Healthcare Provider Details

I. General information

NPI: 1093004434
Provider Name (Legal Business Name): NATHANIEL M PASCUAL, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 01/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8540 SCARBOROUGH DR STE 370
COLORADO SPRINGS CO
80920-7519
US

IV. Provider business mailing address

PO BOX 64080
COLORADO SPRINGS CO
80962-4080
US

V. Phone/Fax

Practice location:
  • Phone: 719-445-9167
  • Fax: 888-900-1252
Mailing address:
  • Phone: 719-445-9167
  • Fax: 888-900-1252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: NATHANIEL PASCUAL
Title or Position: PRESIDENT
Credential: MD
Phone: 719-445-9167