Individual
DR. EGLE ASTA BAKANAUSKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1455 MAIN ST, SUITE 100, WINDSOR, CO 80550-5559
(970) 686-3950
(970) 686-3960
Mailing address
1455 MAIN ST, SUITE 100, WINDSOR, CO 80550-5559
(970) 686-3950
(970) 686-3960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39763
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56907311
—
CO
01
—
P00877649
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
01/23/2007
Last updated
01/19/2015
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