MEDICARE: THOMAS LEE ENGLERT 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	20740	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

General Provider Information

NPI Number	:	1508861832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS LEE ENGLERT MD

Provider Business Mailing Address
First Line	:	1627 E 18TH ST
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-4209
Country	:	US
Telephone Number	:	970-663-0135
Fax Number	:	970-461-1422

Provider Business Practice Location Address
First Line	:	1900 BOISE AVE
Second Line	:	STE 410
City	:	LOVELAND
State	:	CO
Zip	:	80538-5004
Country	:	US
Telephone Number	:	970-667-2009
Fax Number	:	970-667-2103

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	03/14/2008

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Directions to “ THOMAS LEE ENGLERT MD” Practice Location

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