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General NPI Number Information
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NPI Number | 1790780989
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Entity Type | Individual
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Provider Name | EDWIN ANSELMI MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 7960 S UNIVERSITY BLVD STE 203
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City | CENTENNIAL
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State | CO
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Zip | 80122-3167
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Country | US
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Telephone | 720-344-2680
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Fax | 720-344-2681
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Provider Business Mailing Address
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Address Line | 7960 S UNIVERSITY BLVD STE 203
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City | CENTENNIAL
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State | CO
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Zip | 80122-3167
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Country | US
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Telephone | 720-344-2680
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Fax | 720-344-2681
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39788
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License Number State | CO
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