Provider Demographics
NPI:1396981387
Name:AHNFELDT, ARNOLD LORENTZ (MD)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:LORENTZ
Last Name:AHNFELDT
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 1:3008 SPRINGLAKE CIR W
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3747
Mailing Address - Country:US
Mailing Address - Phone:719-576-0437
Mailing Address - Fax:
Practice Address - Street 1:3008 SPRINGLAKE CIR W
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3747
Practice Address - Country:US
Practice Address - Phone:719-576-0437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18945207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD23525Medicare UPIN