Provider Demographics
NPI:1861631319
Name:KUGELMAS, CARINA P (MD)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:P
Last Name:KUGELMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CARINA
Other - Middle Name:
Other - Last Name:PENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11500 E DORADO AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4144
Mailing Address - Country:US
Mailing Address - Phone:720-352-0679
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38734172V00000X
CODR.0038734208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No172V00000XOther Service ProvidersCommunity Health Worker