Healthcare Provider Details

I. General information

NPI: 1992819130
Provider Name (Legal Business Name): MARCELO KUGELMAS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. MARCELO KUGELMAS

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 E HAMPDEN AVE STE 420
ENGLEWOOD CO
80113-2780
US

IV. Provider business mailing address

499 E HAMPDEN AVE STE 420
ENGLEWOOD CO
80113-2794
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-8888
  • Fax: 866-896-1158
Mailing address:
  • Phone: 303-788-8888
  • Fax: 866-896-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number38784
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: