Provider Demographics
NPI:1942271887
Name:URIGUEN-ASHBY, SAMANTHA (DO)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:URIGUEN-ASHBY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-2417
Mailing Address - Fax:970-490-4173
Practice Address - Street 1:3843 RIO VISTA DR STE 2400
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3379
Practice Address - Country:US
Practice Address - Phone:719-364-5590
Practice Address - Fax:719-364-5591
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07677000207Q00000X
CODR.0062731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0078573Medicaid
NJ094785C04Medicare PIN
I42255Medicare UPIN