Provider Demographics
NPI:1568431542
Name:SEVILLA, MARGARITA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARITA
Middle Name:
Last Name:SEVILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4451
Mailing Address - Fax:970-490-4199
Practice Address - Street 1:9475 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-7802
Practice Address - Country:US
Practice Address - Phone:303-470-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47995207Q00000X
MN49043207Q00000X
CODR.0054478207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO025702OtherKAISER COMMERCIAL NUMBER
CO06550746Medicaid
MN080019879Medicare PIN
CO06550746Medicaid
CO382648YK5YMedicare PIN