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NPI Code Detail

MEDICARE: ABBEY PRUDHOMME SEUFER PA-C

MEDICARE: ABBEY PRUDHOMME SEUFER PA-C
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
1363A00000XPhysician Assistant2137CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00621767OTHERCORAILROAD MEDICARE PART B

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457328031
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABBEY PRUDHOMME SEUFER PA-C
Provider Business Mailing Address
First Line : 4803 INNOVATION DR STE 2
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-7308
Country : US
Telephone Number : 970-566-3505
Fax Number : 877-819-1323
Provider Business Practice Location Address
First Line : 4803 INNOVATION DR STE 2
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-7308
Country : US
Telephone Number : 970-566-3505
Fax Number : 877-819-1323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2006
Last Update Date : 12/05/2024

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Practice Location Address:
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Directions to “ ABBEY PRUDHOMME SEUFER PA-C” Practice Location

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