| Pcim | |
|
421 S Tejon St Ste 120 Colorado Springs CO 80903-2139 | |
| (719) 491-1616 | |
| (719) 591-0835 |
| Full Name | Pcim |
|---|---|
| Speciality | Family Medicine |
| Location | 421 S Tejon St Ste 120, Colorado Springs, Colorado |
| Authorized Official Name and Position | William Denam (DO & OWNER) |
| Authorized Official Contact | 7194911616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pcim 1332 N Weber St Colorado Springs CO 80903-2428 Ph: (719) 491-1616 | Pcim 421 S Tejon St Ste 120 Colorado Springs CO 80903-2139 Ph: (719) 491-1616 |
| NPI Number | 1720627011 |
|---|---|
| Provider Enumeration Date | 01/03/2020 |
| Last Update Date | 10/22/2021 |
| Certification Date | 10/22/2021 |
| Medicare PECOS PAC ID | 9335577279 |
|---|---|
| Medicare Enrollment ID | O20200309000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720627011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | William L Denam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770541336 PECOS PAC ID: 8729980511 Enrollment ID: I20040122000718 |
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