Individual
CARLOS HUMBERTO CORRAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11700 W 2ND PL STE 280, LAKEWOOD, CO 80228-1717
(720) 321-8680
(720) 321-8681
Mailing address
11700 W 2ND PL STE 280, LAKEWOOD, CO 80228-1717
(720) 321-8680
(720) 321-8681
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
101130
MT
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
59284
CO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
90170
NM
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
G2120
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000X3247
SALUD PROGRAMS MEDICAID
NM
05
—
122858703
—
TX
01
—
330003968
RAILROAD MEDICARE
—
01
—
900522525
MEDICARE GROUP
NM
Enumeration date
11/14/2005
Last updated
11/23/2021
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