Provider Demographics
NPI:1134402415
Name:ATCHIE, BENJAMIN (DO)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:
Last Name:ATCHIE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:499 E. HAMPDEN AVENUE
Practice Address - Street 2:SUITE 380
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3877
Practice Address - Country:US
Practice Address - Phone:720-493-3345
Practice Address - Fax:720-874-4437
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO571452085R0202X, 2085R0202X, 2085R0202X
NE15072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1134402415Medicaid
IA1134402415Medicaid
AZ174959Medicaid
OK200654570AMedicaid
CO79480501Medicaid
UT1134402415Medicaid
NM06009778Medicaid
MO1134402415Medicaid
KS201140730AMedicaid
CO79480501Medicaid
MO1134402415Medicaid
NE$$$$$$$$$04Medicaid
AZ174959Medicaid
KS201140730AMedicaid
NE$$$$$$$$$02Medicaid
MT1134402415Medicaid
CO511643ZLJ3Medicare PIN
CO511643YQ33Medicare UPIN
NE$$$$$$$$$05Medicaid
NE$$$$$$$$$07Medicaid
UT1134402415Medicaid
CO79480501Medicaid
NENA1215102Medicare PIN
CO511643YQN9Medicare UPIN
IA1134402415Medicaid
NENA1214101Medicare PIN
KSKA3249079Medicare PIN