Provider Demographics
NPI:1992819130
Name:KUGELMAS, MARCELO (MD)
Entity type:Individual
Prefix:DR
First Name:MARCELO
Middle Name:
Last Name:KUGELMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARCELO
Other - Middle Name:
Other - Last Name:KUGELMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:499 E HAMPDEN AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2794
Mailing Address - Country:US
Mailing Address - Phone:303-788-8888
Mailing Address - Fax:866-896-1158
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:STE 420
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2780
Practice Address - Country:US
Practice Address - Phone:303-788-8888
Practice Address - Fax:866-896-1158
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38784207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41779525Medicaid
COP00187539Medicare PIN
CO41779525Medicaid