MEDICARE: COLM ACUFF DO

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	207P00000X	Emergency Medicine Physician	56255	GA
2	207P00000X	Emergency Medicine Physician	OP60931223	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	657255344A	OTHER	GA	PEACH STATE HEALTH PLAN
2	967531	OTHER	GA	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	N362160	OTHER	GA	WELLCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487605671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLM ACUFF DO

Provider Business Mailing Address
First Line	:	6896 W SNOWVILLE RD
Second Line	:
City	:	BRECKSVILLE
State	:	OH
Zip	:	44141-3214
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1455 BATTERSBY AVE
Second Line	:
City	:	ENUMCLAW
State	:	WA
Zip	:	98022-3634
Country	:	US
Telephone Number	:	912-350-3849
Fax Number	:

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

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	03/07/2023

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Directions to “ COLM ACUFF DO” Practice Location

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