Individual
BENJAMIN M DURTSCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
1400 E BOULDER ST STE 2508, COLORADO SPRINGS, CO 80909-5533
(719) 365-6999
(719) 365-2837
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-4034
(970) 490-4347
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
2012029913
MO
367H00000X
Anesthesiologist Assistant
Primary
ANT.0000129
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265780092
—
MO
01
—
431560263
TRICARE
MO
01
—
P01129105
RR MCR
MO
Enumeration date
08/28/2012
Last updated
04/17/2020
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