Provider Demographics
NPI:1699754713
Name:ARGUELLO, SILVIANO L (MD)
Entity type:Individual
Prefix:
First Name:SILVIANO
Middle Name:L
Last Name:ARGUELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 W ORMAN AVE
Mailing Address - Street 2:MT 118
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-1430
Mailing Address - Country:US
Mailing Address - Phone:719-549-3315
Mailing Address - Fax:719-549-3332
Practice Address - Street 1:401 MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-2138
Practice Address - Country:US
Practice Address - Phone:719-545-3555
Practice Address - Fax:719-545-1517
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO24610207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01246107Medicaid
COD24477Medicare UPIN