Dr BENJAMIN MICELI is a male medical professional, specializing in Physician Assistant. He graduated in 2013.
POUDRE VALLEY MEDICAL GROUP LLC
8890 N UNION BLVD
COLORADO SPRINGS
CO
809202701
Tel:
| Npi | 1043633324 |
| Pac Id | 2163654922 |
| Professional Enrollment Id | I20140409000582 |
| Last Name | MICELI |
| First Name | BENJAMIN |
| Middle Name | |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 2013 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | POUDRE VALLEY MEDICAL GROUP LLC |
| Group Practice Pac Id | 9638208549 |
| Number Of Group Practice Members | 1002 |
| Line 1 Street Address | 8890 N UNION BLVD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | Y |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 809202701 |
| Phone Number | |
| Hospital Affiliation Ccn 1 | 060119 |
| Hospital Affiliation Lbn 1 | MEDICAL CENTER OF THE ROCKIES |
| Hospital Affiliation Ccn 2 | 060010 |
| Hospital Affiliation Lbn 2 | POUDRE VALLEY HOSPITAL |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
| Hospital Affiliation Lbn 4 | |
| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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