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MOUNTAIN BLUE CANCER CARE CENTER PC NPI 1699009084


NPI Information

NPI: 1699009084
Provider Name: MOUNTAIN BLUE CANCER CARE CENTER PC
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
799 E HAMPDEN AVE STE 500
ENGLEWOOD, CO
ZIP 80113
Phone: (303) 788-8675
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MOUNTAIN BLUE CANCER CARE CENTER PC is a hematology and oncology internal medicine in Englewood, CO. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. MOUNTAIN BLUE CANCER CARE CENTER PC NPI is 1699009084. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

799 E HAMPDEN AVE STE 500
ENGLEWOOD, CO
ZIP 80113-777
Phone: (303) 788-8675
Fax: (303) 788-8489

The provider's authorized official is Samir E Witta .
The authorized official title is Owner and has the following contact phone number (303) 788-8675.

The enumeration date for this NPI number is 10/1/2009 and was last updated on 4/30/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & OncologyCO39762COLORADOYes
2207RH0003XInternal MedicineHematology & Oncology39764COLORADONo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
182076529MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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