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General NPI Number Information
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NPI Number | 1558718619
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Entity Type | Individual
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Provider Name | VINICIUS KNABBEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 1501 N WILLIAMSON AVE
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City | WINSLOW
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State | AZ
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Zip | 86047-2735
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Country | US
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Telephone | 928-289-4691
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Fax |
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Provider Business Mailing Address
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Address Line | 9878 W BELLEVIEW AVE # 5114
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City | DENVER
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State | CO
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Zip | 80123-2101
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Country | US
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Telephone | 844-466-6827
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 58256
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License Number State | AZ
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