Organization
COLORADO SPRINGS INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKY L. BONATO (PRACTICE MANAGER)
(719) 633-5515
Entity
Organization
Contact information
Practice address
175 S UNION BLVD, SUITE 350, COLORADO SPRINGS, CO 80910-3113
(719) 633-5515
(719) 471-2258
Mailing address
175 S UNION BLVD, SUITE 350, COLORADO SPRINGS, CO 80910-3113
(719) 633-5515
(719) 471-2258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04015269
—
CO
Enumeration date
11/10/2005
Last updated
07/22/2013
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