Provider Demographics
NPI:1629241450
Name:VOGEL, REBECCA SUSAN (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUSAN
Last Name:VOGEL
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3455 LUTHERAN PKWY
Mailing Address - Street 2:SUITE 290
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6028
Mailing Address - Country:US
Mailing Address - Phone:303-940-8200
Mailing Address - Fax:303-940-8400
Practice Address - Street 1:11700 W 2ND PL
Practice Address - Street 2:MOB 2 STE 210
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-8022
Practice Address - Country:US
Practice Address - Phone:720-321-8080
Practice Address - Fax:720-321-8081
Is Sole Proprietor?:No
Enumeration Date:2008-04-13
Last Update Date:2020-11-24
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Provider Licenses
StateLicense IDTaxonomies
CODR.0052725208600000X
CO527252086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO52725OtherCO LICENSE