Healthcare Provider Details

I. General information

NPI: 1841493293
Provider Name (Legal Business Name): PETER WILLIAM SCHLICKMAN PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 03/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 WILLIAMS ST SUITE 300
DENVER CO
80218
US

IV. Provider business mailing address

1800 WILLIAMS ST SUITE 300
DENVER CO
80218
US

V. Phone/Fax

Practice location:
  • Phone: 972-955-6818
  • Fax:
Mailing address:
  • Phone: 972-955-6818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number5302037147
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number19059
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: