MEDICARE: DR. JAMES N MEEUWSEN 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	207VG0400X	Gynecology Physician	21407	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

General Provider Information

NPI Number	:	1376539643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES N MEEUWSEN MD

Provider Business Mailing Address
First Line	:	1817 CHIANTI CT
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81001-9700
Country	:	US
Telephone Number	:	719-251-8304
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 N GRAND AVE
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-2700
Country	:	US
Telephone Number	:	719-543-6755
Fax Number	:	719-583-2236

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	01/15/2016

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