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NPI Code Detail

MEDICARE: DR. CHUCK R COLAS DO

MEDICARE: DR. CHUCK R COLAS 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
1208D00000XGeneral Practice Physician20A7380CA
2208D00000XGeneral Practice PhysicianO-0668ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831204288
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHUCK R COLAS DO
Provider Business Mailing Address
First Line : 415 6TH STREET
Second Line : ATTN: PHYSICIAN SERVICES
City : LEWISTON
State : ID
Zip : 83501-2434
Country : US
Telephone Number : 208-750-7462
Fax Number : 208-750-7467
Provider Business Practice Location Address
First Line : 2315 8TH ST
Second Line :
City : LEWISTON
State : ID
Zip : 83501-7301
Country : US
Telephone Number : 208-746-1383
Fax Number : 833-941-3874
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 02/25/2026

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Directions to “ DR. CHUCK R COLAS DO” Practice Location

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