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Individual

DR. ERIN C PRENGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
10700 E. GEDDES AVE SUITE 200, ATTN CREDENTIALING, ENGLEWOOD, CO 80112
(303) 761-9190
(303) 761-6278
Mailing address
10700 E. GEDDES AVE SUITE 200, ATTN CREDENTIALING, ENGLEWOOD, CO 80112
(303) 761-9190
(303) 761-6278

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
3484
AZ
2085R0202X
Diagnostic Radiology Physician
32827
CO
2085R0202X
Diagnostic Radiology Physician
3484
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01328277
CO
01
1Z7046
HEALTH NET OF AZ
AZ
05
481846
AZ
05
84059792913
NE
05
84089712600
NE
01
AZ0861410
BCBSAZ
AZ
01
XPY193671
MEDI-CAL MEDICAID
AZ
Enumeration date
02/20/2006
Last updated
09/29/2010
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