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2301 House Ave Suite 201 Cheyenne WY 82001-3177 | |
| (307) 635-9131 | |
| (307) 637-8300 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Nephrology |
| Location | 2301 House Ave, Cheyenne, Wyoming |
| Authorized Official Name and Position | Jean A Halpern (CEO) |
| Authorized Official Contact | 3076359131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2301 House Ave Suite 201 Cheyenne WY 82001-3177 Ph: (307) 635-9131 | 2301 House Ave Suite 201 Cheyenne WY 82001-3177 Ph: (307) 635-9131 |
| NPI Number | 1235231028 |
|---|---|
| Provider Enumeration Date | 09/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235231028 | NPI | - | NPPES |
| 05826001 | Other | WY | BLUE CROSS BLUE SHIELD |
| CQ3266 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
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