MEDICARE: ELISA CARNIEL 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	207R00000X	Internal Medicine Physician	046885	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	018825	OTHER	CO	KAISER COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1881740470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISA CARNIEL MD

Provider Business Mailing Address
First Line	:	1835 FRANKLIN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1126
Country	:	US
Telephone Number	:	303-266-0413
Fax Number	:

Provider Business Practice Location Address
First Line	:	1835 FRANKLIN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1126
Country	:	US
Telephone Number	:	303-266-0413
Fax Number	:

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	09/17/2008

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