Healthcare Provider Details

I. General information

NPI: 1740508365
Provider Name (Legal Business Name): ZACHARY JOHN ENGELBERT D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2010
Last Update Date: 06/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7761 SHAFFER PKWY STE 225
LITTLETON CO
80127
US

IV. Provider business mailing address

1805 SHEA CENTER DR STE 301
HIGHLANDS RANCH CO
80129-2251
US

V. Phone/Fax

Practice location:
  • Phone: 303-932-2988
  • Fax:
Mailing address:
  • Phone: 303-357-2559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0053541
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: