Healthcare Provider Details

I. General information

NPI: 1275620304
Provider Name (Legal Business Name): AUGUSTIN ATTWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 W COLFAX AVE
LAKEWOOD CO
80214-5433
US

IV. Provider business mailing address

3333 S WADSWORTH BLVD STE. D-100
LAKEWOOD CO
80227-5122
US

V. Phone/Fax

Practice location:
  • Phone: 303-573-9951
  • Fax:
Mailing address:
  • Phone: 303-205-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number38975
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: