Healthcare Provider Details

I. General information

NPI: 1699237370
Provider Name (Legal Business Name): DANIEL ROBERT WELLS-PRADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DANIEL ROBERT WELLS MD

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5075 LINCOLN ST
DENVER CO
80216-2015
US

IV. Provider business mailing address

4725 HIGH ST
DENVER CO
80216-2220
US

V. Phone/Fax

Practice location:
  • Phone: 303-458-5302
  • Fax: 303-433-7452
Mailing address:
  • Phone: 303-458-5302
  • Fax: 303-583-0152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0068907
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: