Individual
DR. NICOLA D. DEMACOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4674 SNOW MESA DR, SUITE 100, FORT COLLINS, CO 80528-8615
(970) 482-3712
(970) 482-4057
Mailing address
4674 SNOW MESA DR, SUITE 100, FORT COLLINS, CO 80528-8615
(970) 482-3712
(970) 266-4190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
49240
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81139004
—
CO
01
—
P00944697
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
12/23/2005
Last updated
01/19/2015
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