Provider Demographics
NPI:1952310633
Name:ALBERT, NILS P (MD)
Entity Type:Individual
Prefix:
First Name:NILS
Middle Name:P
Last Name:ALBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3464 S WILLOW ST # 162
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4531
Mailing Address - Country:US
Mailing Address - Phone:303-755-2900
Mailing Address - Fax:303-745-7997
Practice Address - Street 1:605 PARFET ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5576
Practice Address - Country:US
Practice Address - Phone:303-462-2273
Practice Address - Fax:303-462-2274
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36583207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86038745Medicaid
CO800513Medicare ID - Type Unspecified
H17919Medicare UPIN