Provider Demographics
NPI:1164089678
Name:ANNE W ESTARES DO PC
Entity Type:Organization
Organization Name:ANNE W ESTARES DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:WIERMAN
Authorized Official - Last Name:ESTARES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-599-7949
Mailing Address - Street 1:5495 CREIGHTON CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-8158
Mailing Address - Country:US
Mailing Address - Phone:719-314-5254
Mailing Address - Fax:719-439-9500
Practice Address - Street 1:5901 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-1941
Practice Address - Country:US
Practice Address - Phone:719-314-5254
Practice Address - Fax:719-439-9500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR.0051694OtherDOCTOR OF OSTEOPATHIC MEDICINE