MEDICARE: DR. ANN RUSSELL ENGEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DR.0066144	CO
2	207Q00000X	Family Medicine Physician	26455	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285743385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN RUSSELL ENGEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 7188
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85281-0007
Country	:	US
Telephone Number	:	480-231-2020
Fax Number	:	480-755-5069

Provider Business Practice Location Address
First Line	:	4344 WOODLANDS BLVD STE 260
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-2801
Country	:	US
Telephone Number	:	303-649-3155
Fax Number	:	303-649-3156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/20/2021

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