| Hope Internal Medicine Of Pueblo, Prof Llc | |
|
728 N Elizabeth St Pueblo CO 81003-2335 | |
| (719) 543-9158 | |
| (719) 544-1958 |
| Full Name | Hope Internal Medicine Of Pueblo, Prof Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 728 N Elizabeth St, Pueblo, Colorado |
| Authorized Official Name and Position | Opeymi A Banjoko (OWNER) |
| Authorized Official Contact | 7195439158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope Internal Medicine Of Pueblo, Prof Llc 728 N Elizabeth St Pueblo CO 81003-2335 Ph: (719) 543-9158 | Hope Internal Medicine Of Pueblo, Prof Llc 728 N Elizabeth St Pueblo CO 81003-2335 Ph: (719) 543-9158 |
| NPI Number | 1184998387 |
|---|---|
| Provider Enumeration Date | 03/06/2012 |
| Last Update Date | 07/08/2022 |
| Medicare PECOS PAC ID | 8628225703 |
|---|---|
| Medicare Enrollment ID | O20120824000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184998387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 48210 (Colorado) | Primary |
| Provider Name | Opeyemi A Banjoko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134373020 PECOS PAC ID: 6406993609 Enrollment ID: I20091020000748 |
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