Provider Demographics
NPI:1972539393
Name:KNAUER, SALLY A (MD)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:A
Last Name:KNAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2121 E. HARMONY RD.
Mailing Address - Street 2:STE 290
Mailing Address - City:FORT COLLINS,
Mailing Address - State:CO
Mailing Address - Zip Code:80528
Mailing Address - Country:US
Mailing Address - Phone:970-224-9890
Mailing Address - Fax:970-224-9800
Practice Address - Street 1:2121 E. HARMONY RD.
Practice Address - Street 2:STE 290
Practice Address - City:FORT COLLINS,
Practice Address - State:CO
Practice Address - Zip Code:80528
Practice Address - Country:US
Practice Address - Phone:970-224-9890
Practice Address - Fax:970-224-9800
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO26881207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01268812Medicaid
CO0187630001Medicare NSC
D28398Medicare UPIN
CN6918Medicare ID - Type Unspecified
COCN6908Medicare UPIN