MEDICARE: CAMERON COLVIG 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	207P00000X	Emergency Medicine Physician	036119310	IL

General Provider Information

NPI Number	:	1689820755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON COLVIG MD

Provider Business Mailing Address
First Line	:	1700 WHEELING ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-7211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PSC 482
Second Line	:	BOX 2647
City	:	FPO
State	:	AP
Zip	:	96362-9998
Country	:	US
Telephone Number	:	315-643-3778
Fax Number	:

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

Provider Enumeration Date	:	08/08/2008
Last Update Date	:	12/25/2021

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