Organization
ASSOCIATES IN GENERAL AND VASCULAR SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL MELLA (PRACTICE ADMINISTRATOR)
(719) 630-8111
Entity
Organization
Contact information
Practice address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 630-8111
Mailing address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 630-8111
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CT1628
RAILROAD MEDICARE ID
CO
Enumeration date
03/07/2007
Last updated
02/26/2009
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