Provider Demographics
NPI:1306927173
Name:CUTARELLI, PAUL EZIO (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:EZIO
Last Name:CUTARELLI
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 1:7887 E BELLEVIEW AVE
Mailing Address - Street 2:#180
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6015
Mailing Address - Country:US
Mailing Address - Phone:303-486-2020
Mailing Address - Fax:303-221-3434
Practice Address - Street 1:7887 E BELLEVIEW AVE
Practice Address - Street 2:#180
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-6015
Practice Address - Country:US
Practice Address - Phone:303-486-2020
Practice Address - Fax:303-221-3434
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38485207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO93401779Medicaid
CO93401779Medicaid
COGO9166Medicare UPIN