Basic Information
Provider Information
NPI: 1548462294
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROCKEL
FirstName: MEGAN
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 876
Address2: UNIVERSITY PHYSICIANS INC
City: AURORA
State: CO
PostalCode: 800400876
CountryCode: US
TelephoneNumber: 3034937000
FaxNumber:  
Practice Location
Address1: 13123 E 16TH AVE
Address2: THE CHILDRENS HOSPITAL
City: AURORA
State: CO
PostalCode: 800457106
CountryCode: US
TelephoneNumber: 7207771234
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/04/2007
LastUpdateDate: 04/18/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP3000X49643COY Allopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology

No ID Information.


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