Provider Demographics
NPI:1013916881
Name:RIPP, CHARLES HERBERT (MD)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:HERBERT
Last Name:RIPP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8000 E MAPLEWOOD AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4727
Mailing Address - Country:US
Mailing Address - Phone:719-358-8270
Mailing Address - Fax:719-358-8299
Practice Address - Street 1:8540 SCARBOROUGH DR
Practice Address - Street 2:SUITE 370
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7502
Practice Address - Country:US
Practice Address - Phone:719-358-8270
Practice Address - Fax:719-358-8299
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2018-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO27928207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01279280Medicaid
E04730Medicare UPIN
76281Medicare ID - Type Unspecified