Healthcare Provider Details

I. General information

NPI: 1457093080
Provider Name (Legal Business Name): ANISA MARIE WAKIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5589 ARGONNE ST
DENVER CO
80249-8989
US

IV. Provider business mailing address

5589 ARGONNE ST
DENVER CO
80249-8989
US

V. Phone/Fax

Practice location:
  • Phone: 303-371-0330
  • Fax:
Mailing address:
  • Phone: 303-371-0330
  • Fax: 303-344-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0075888
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: