MEDICARE: DR. PAULA E. WEGERT 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	2081P0004X	Spinal Cord Injury Medicine Physician	K1953	TX
2	2081P0004X	Spinal Cord Injury Medicine Physician	47101	CO

General Provider Information

NPI Number	:	1972607026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULA E. WEGERT MD

Provider Business Mailing Address
First Line	:	4800 HAPPY CANYON RD STE 220
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80237-1074
Country	:	US
Telephone Number	:	720-710-5988
Fax Number	:	720-707-1627

Provider Business Practice Location Address
First Line	:	325 S PARKSIDE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3134
Country	:	US
Telephone Number	:	719-630-8000
Fax Number	:	719-520-0387

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

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	07/17/2023

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