Provider Demographics
NPI:1902947732
Name:RAUZZINO, MICHAEL JOSEPH (MD, FACS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:RAUZZINO
Suffix:
Gender:M
Credentials:MD, FACS
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10099 RIDGEGATE PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5534
Mailing Address - Country:US
Mailing Address - Phone:303-947-5838
Mailing Address - Fax:303-790-1800
Practice Address - Street 1:10099 RIDGEGATE PKWY STE 310
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5534
Practice Address - Country:US
Practice Address - Phone:303-790-1800
Practice Address - Fax:303-790-1809
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO42121207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO70303363Medicaid
F84066Medicare UPIN
CO70303363Medicaid