Colorado Medical Group, Pllc

NPI #1700573201 in Longmont, Colorado

Provider Information

NPI Number: 1700573201
Entity Type: Organization
Organization Name: Colorado Medical Group, Pllc
Primary Specialty: Surgery - Vascular Surgery
Enumeration Date: Apr 24, 2023
Last Updated: Apr 24, 2023

Practice Location

Address: 1551 PROFESSIONAL LN UNIT 240
City: Longmont
State: Colorado
ZIP Code: 80501-6967
Phone: (800) 991-6117

Authorized Official

Name: ALI N WAZNI, MD
Title: CHIEF MEDICAL OFFICER
Phone: (518) 817-1747

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X
Surgery - Vascular Surgery — Vascular Surgery	2086S0129X	Primary

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