Ingenious Personalized Medicine, LLC
Organization Active NPI Clinical Medical Laboratory · Colorado Springs, CO
NPI 1083280978 · NPPES record last updated Jan 9, 2023
Key facts
- NPI
- 1083280978
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- Legal business name
- INGENIOUS PERSONALIZED MEDICINE, LLC
- Practice address
- 6915 Tutt Boulevard
Suite 110a
Colorado Springs, CO 80923-3591 - Phone
- (786) 221-1734
- Fax
- (305) 891-4228
- NPI assigned
- Jun 1, 2021
- Organization subpart
- No
Authorized official
- Name
- Scott Daniel Segal, MD
- Title
- Ceo
- Phone
- (888) 852-6672
Corporate family (same tax ID) 2
Practitioners 1
-
Scott Segal, MD
National Provider Directory
- Tax ID family
- Ingenious Personalized Medicine LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Yes |
Addresses
Primary practice location
6915 Tutt Boulevard
Suite 110a
Colorado Springs, CO 80923-3591
Mailing address
1065 NE 125TH Street
Suite 300
North Miami, FL 33161-5833
Phone (786) 221-1734
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.