MEDICARE: FREDERICK V COVILLE MD

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	174400000X	Specialist
2	207X00000X	Orthopaedic Surgery Physician	22413	CO

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336184886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERICK V COVILLE MD

Provider Business Mailing Address
First Line	:	4900 S MONACO ST
Second Line	:	#210
City	:	DENVER
State	:	CO
Zip	:	80237-3486
Country	:	US
Telephone Number	:	303-789-2663
Fax Number	:	303-788-4871

Provider Business Practice Location Address
First Line	:	799 E HAMPDEN AVE
Second Line	:	SUITE 400
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-2766
Country	:	US
Telephone Number	:	303-789-2663
Fax Number	:	303-788-4871

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	04/03/2013

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