MEDICARE: MR. ARBEN VUTHI P.A

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1699968420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARBEN VUTHI P.A

Provider Business Mailing Address
First Line	:	1650 COCHRANE CIRCLE BLDG 7505
Second Line	:	USA MEDDAC, EVANS ACH
City	:	FT CARSON
State	:	CO
Zip	:	80913-1041
Country	:	US
Telephone Number	:	719-526-3563
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 COCHRANE CIRCLE BLDG 7505
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80913-0000
Country	:	US
Telephone Number	:	719-525-3563
Fax Number	:

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

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	07/12/2013

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