Healthcare Provider Details

I. General information

NPI: 1275808586
Provider Name (Legal Business Name): MEGHAN ANN CROTEAU FELS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGHAN ANN CROTEAU D.O.

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 W 20TH ST SUITE 201
GREELEY CO
80634-9637
US

IV. Provider business mailing address

6801 W 20TH ST SUITE 201
GREELEY CO
80634-9637
US

V. Phone/Fax

Practice location:
  • Phone: 970-350-5828
  • Fax: 970-810-4210
Mailing address:
  • Phone: 970-350-5828
  • Fax: 970-810-4210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0055167
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: