Provider Demographics
NPI:1538116447
Name:PARTNERS IN HEALTH FAMILY MEDICINE, PC
Entity Type:Organization
Organization Name:PARTNERS IN HEALTH FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:ENGELSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-429-6600
Mailing Address - Street 1:3520 W 92ND AVE
Mailing Address - Street 2:SUITE #104
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031
Mailing Address - Country:US
Mailing Address - Phone:303-429-6600
Mailing Address - Fax:
Practice Address - Street 1:3520 W 92ND AVE
Practice Address - Street 2:SUITE #104
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3303
Practice Address - Country:US
Practice Address - Phone:303-429-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76605728Medicaid
COC800626Medicare PIN