MEDICARE: DR. SASHA LEEANN MONSMA SELBY MBBS

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	69836	MN
2	207P00000X	Emergency Medicine Physician	30744	MN
3	390200000X	Student in an Organized Health Care Education/Training Program	MD2023-0475	NM
4	207P00000X	Emergency Medicine Physician	DR.0072484	CO

General Provider Information

NPI Number	:	1841802204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SASHA LEEANN MONSMA SELBY MBBS

Provider Business Mailing Address
First Line	:	2768 W 22ND AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5108
Country	:	US
Telephone Number	:	507-202-3767
Fax Number	:

Provider Business Practice Location Address
First Line	:	2768 W 22ND AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5108
Country	:	US
Telephone Number	:	507-202-3767
Fax Number	:

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

Provider Enumeration Date	:	08/18/2020
Last Update Date	:	07/09/2024

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