Provider Demographics
NPI:1487631511
Name:OGIN, BRUCE (DO)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:OGIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT 499
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-0499
Mailing Address - Country:US
Mailing Address - Phone:303-336-8304
Mailing Address - Fax:303-780-0787
Practice Address - Street 1:455 SHERMAN
Practice Address - Street 2:SUITE 510
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4405
Practice Address - Country:US
Practice Address - Phone:303-336-8304
Practice Address - Fax:303-780-0787
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18217207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE841134385-13Medicaid
MT3506685Medicaid
KS100271470AMedicaid
WY1075306-00Medicaid
TX058688501Medicaid
NML5024Medicaid
CO01182179Medicaid
KS100271470AMedicaid
COCV2488Medicare PIN