MEDICARE: DR. AUGUSTINE UJUNWA OBINNAH M.D.

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	207R00000X	Internal Medicine Physician	36486	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	OBO53050	OTHER	CO	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1558412494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUGUSTINE UJUNWA OBINNAH M.D.

Provider Business Mailing Address
First Line	:	4809 ARGONNE ST
Second Line	:	SUITE 100
City	:	DENVER
State	:	CO
Zip	:	80249-6834
Country	:	US
Telephone Number	:	303-344-8700
Fax Number	:	303-344-0200

Provider Business Practice Location Address
First Line	:	4809 ARGONNE ST
Second Line	:	SUITE 100
City	:	DENVER
State	:	CO
Zip	:	80249-6834
Country	:	US
Telephone Number	:	303-344-8700
Fax Number	:	303-344-0200

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	02/20/2008

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