Organization
FRONT RANGE INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ERIKA ANN KNUTSON (BUSINESS MANAGER)
(303) 788-1620
Entity
Organization
Contact information
Practice address
499 E HAMPDEN AVE, SUITE 400, ENGLEWOOD, CO 80113-2780
(303) 788-1620
(303) 788-4097
Mailing address
499 E HAMPDEN AVE, SUITE 400, ENGLEWOOD, CO 80113-2780
(303) 788-1620
(303) 788-4097
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26561
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04008470
—
CO
01
—
CS6748
RAILROAD MEDICARE
CO
01
—
FR96708
BLUE CROSS AND BLUE SHIEL
CO
Enumeration date
11/29/2007
Last updated
11/29/2007
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