Organization
SURGICAL CONSULTANTS OF PUEBLO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL RAYMOND RADWAY MD (PRESIDENT)
(719) 561-1161
Entity
Organization
Contact information
Practice address
1026 W ABRIENDO AVE, PUEBLO, CO 81004-1128
(719) 561-1161
Mailing address
124 CARRILLON LN, PUEBLO, CO 81005
(719) 561-1161
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20508
CO
Other
Enumeration date
02/06/2007
Last updated
08/22/2020
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