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General NPI Number Information
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NPI Number | 1164089678
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Entity Type | Organization
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Legal Business Name | ANNE W ESTARES DO PC
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Dates
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Enumeration Date | 05/21/2019
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Last Update Date | 05/21/2019
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Provider Practice Location Address
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Address Line | 5901 CORPORATE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1941
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Country | US
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Telephone | 719-314-5254
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Fax | 719-439-9500
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Provider Business Mailing Address
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Address Line | 5495 CREIGHTON CT
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-8158
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Country | US
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Telephone | 719-314-5254
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Fax | 719-439-9500
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ANNE WIERMAN ESTARES
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Credential | DO
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Telephone | 719-599-7949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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