Provider Demographics
NPI:1407993769
Name:SERGEW, AMEN (MD)
Entity Type:Individual
Prefix:
First Name:AMEN
Middle Name:
Last Name:SERGEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 JACKSON STREET
Mailing Address - Street 2:NATIONAL JEWISH HEALTH
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2641
Mailing Address - Country:US
Mailing Address - Phone:303-388-4461
Mailing Address - Fax:303-398-1211
Practice Address - Street 1:1400 JACKSON STREET
Practice Address - Street 2:NATIONAL JEWISH HEALTH
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-2641
Practice Address - Country:US
Practice Address - Phone:303-388-4461
Practice Address - Fax:303-270-2206
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2023-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO44785207R00000X, 207RP1001X
AZ50845207R00000X
CO48958207RC0200X
WI1801207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO55382568Medicaid
CO306205Medicare PIN