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General NPI Number Information
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NPI Number | 1477943421
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Entity Type | Organization
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Legal Business Name | OPTUM MEDICAL SERVICES OF COLORADO, P.C.
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 13625 TECHNOLOGY DR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-2252
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Country | US
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Telephone | 952-917-7982
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Fax |
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Provider Business Mailing Address
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Address Line | 13625 TECHNOLOGY DR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-2252
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Country | US
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Telephone | 952-917-7982
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD J SHUMACHER
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Credential | M.D.
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Telephone | 240-683-5331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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