Provider Demographics
NPI:1831275064
Name:LEMBITZ, DEANNE (MD)
Entity type:Individual
Prefix:DR
First Name:DEANNE
Middle Name:
Last Name:LEMBITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 ROYAL VISTA CIRCLE
Mailing Address - Street 2:STE 7
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-9371
Mailing Address - Country:US
Mailing Address - Phone:970-530-0575
Mailing Address - Fax:970-530-0581
Practice Address - Street 1:4630 ROYAL VISTA CIRCLE
Practice Address - Street 2:STE 7
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-9371
Practice Address - Country:US
Practice Address - Phone:970-530-0575
Practice Address - Fax:970-530-0581
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO 28234207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01282342Medicaid
COLER4658OtherBLUE CROSS BLUE SHIELD
COLER4658OtherBLUE CROSS BLUE SHIELD
COCR4658Medicare ID - Type Unspecified