Healthcare Provider Details

I. General information

NPI: 1629993654
Provider Name (Legal Business Name): MATTHEW WILLIAM DAVIS PARAMEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

6855 W 48TH AVE
WHEAT RIDGE CO
80033-3538
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-2566
  • Fax:
Mailing address:
  • Phone: 303-947-9519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number030670
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: