Healthcare Provider Details

I. General information

NPI: 1225004260
Provider Name (Legal Business Name): RAFAEL S CAMPANINI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 06/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SHERMAN ST STE 510
DENVER CO
80203-4400
US

IV. Provider business mailing address

455 SHERMAN ST STE 510
DENVER CO
80203-4400
US

V. Phone/Fax

Practice location:
  • Phone: 303-744-8644
  • Fax: 303-780-0787
Mailing address:
  • Phone: 303-744-8644
  • Fax: 303-780-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number38917
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number38917
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: