Provider Demographics
NPI:1225056260
Name:SANTAGUIDA, RIK (MD)
Entity Type:Individual
Prefix:
First Name:RIK
Middle Name:
Last Name:SANTAGUIDA
Suffix:
Gender:M
Credentials:MD
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 3429
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80437-3429
Mailing Address - Country:US
Mailing Address - Phone:303-674-8700
Mailing Address - Fax:303-674-0313
Practice Address - Street 1:3951 EVERGREEN PARKWAY
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439
Practice Address - Country:US
Practice Address - Phone:303-674-8700
Practice Address - Fax:303-674-0313
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22538207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01225382Medicaid
CO197878Medicare ID - Type Unspecified
CAD28538Medicare UPIN