Provider Demographics
NPI:1912944190
Name:ENGELBRETH, LEE A (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:A
Last Name:ENGELBRETH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LEE
Other - Middle Name:A
Other - Last Name:STIGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43319208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO017426OtherKAISER-COMMERCIAL NUMBER
CO46456562Medicaid
COC806224Medicare PIN
COCOA105211Medicare PIN
COI47144Medicare UPIN