Provider Demographics
NPI:1184666323
Name:DANDO, CARL F (MD,RVT,RPVI, RPHS)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:F
Last Name:DANDO
Suffix:
Gender:M
Credentials:MD,RVT,RPVI, RPHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 450
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:CO
Mailing Address - Zip Code:81632-0450
Mailing Address - Country:US
Mailing Address - Phone:970-766-8346
Mailing Address - Fax:888-979-8915
Practice Address - Street 1:50 BUCK CREED RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620
Practice Address - Country:US
Practice Address - Phone:970-766-8346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN48263207R00000X, 202K00000X
CO49096202K00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN48263OtherLICENSE
MN110012921OtherMEDICARE
CO49096OtherLICENSE
CO67723063Medicaid