Individual
DR. CHARLES ERNEST FUENZALIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1444 S POTOMAC ST, SUITE 300, AURORA, CO 80012-4508
(303) 750-0822
(303) 750-1298
Mailing address
4900 S MONACO ST, SUITE 210, DENVER, CO 80237-3486
(303) 750-0822
(303) 750-1298
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25164
CO
207RC0001X
Clinical Cardiac Electrophysiology Physician
25164
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01251644
—
CO
05
—
100171260C
—
KS
05
—
10026280600
—
NE
05
—
10026280700
—
NE
05
—
10026280800
—
NE
05
—
10026281000
—
NE
05
—
10026281200
—
NE
05
—
10026283100
—
NE
05
—
1730175688
—
WY
05
—
1982948089
—
NE
01
—
271395YN6L
MEDICARE
CO
05
—
35476273
—
NM
Enumeration date
09/26/2005
Last updated
01/26/2022
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