Individual
SCOTT DAVID SEGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1400 E BOULDER ST, COLORADO SPRINGS, CO 80909
(719) 365-1292
(719) 365-6997
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-2403
(970) 490-4173
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DO23435
OR
207Q00000X
Family Medicine Physician
Primary
DR.0052634
CO
207Q00000X
Family Medicine Physician
OP00002054
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138926
MEDICARE PTAN
OR
05
—
244091
—
OR
Enumeration date
01/21/2006
Last updated
07/03/2018
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