Provider Demographics
NPI:1730377557
Name:ROBERT E. BENKERT, MD PC
Entity type:Organization
Organization Name:ROBERT E. BENKERT, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BENKERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-431-3727
Mailing Address - Street 1:5728 S GALLUP ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2193
Mailing Address - Country:US
Mailing Address - Phone:303-431-3727
Mailing Address - Fax:303-431-3692
Practice Address - Street 1:9201 W 44TH AVE
Practice Address - Street 2:UNIT B
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-3084
Practice Address - Country:US
Practice Address - Phone:303-431-3727
Practice Address - Fax:303-431-3692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33028207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY113422100Medicaid
97133OtherAETNA
COBE08741OtherANTHEM BLUE CROSS BLUE SH
CO04016366Medicaid
290007401OtherRAILROAD MEDICARE
4140701OtherAETNA PPO/POS
97133OtherAETNA
WY113422100Medicaid