Individual
IMELDA SUELTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2460 OAK HILLS DR, COLORADO SPRINGS, CO 80919-3474
(719) 661-9441
Mailing address
PO BOX 76510, COLORADO SPRINGS, CO 80970-6510
(719) 663-8884
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME38870
CO
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME38870
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013437062
—
CO
01
—
050083513
RAILROAD MEDICARE
CO
01
—
388738
ANTHEM/BLUE CROSS
CO
Enumeration date
05/22/2006
Last updated
09/09/2021
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