Provider Demographics
NPI:1013965144
Name:CONTIGUGLIA, SEBASTIAN ROBERT (MD)
Entity type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:ROBERT
Last Name:CONTIGUGLIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:S
Other - Middle Name:ROBERT
Other - Last Name:CONTIGUGLIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4545 EAST NINTH AVENUE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:303-320-6891
Mailing Address - Fax:303-320-4093
Practice Address - Street 1:4545 EAST NINTH AVENUE
Practice Address - Street 2:SUITE 350
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-320-6891
Practice Address - Fax:303-320-4093
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16568207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01165687Medicaid
6438Medicare ID - Type Unspecified
CO01165687Medicaid