Healthcare Provider Details

I. General information

NPI: 1306863386
Provider Name (Legal Business Name): JENS-PETER WITT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 E 19TH AVE STE 500
DENVER CO
80218-1242
US

IV. Provider business mailing address

1721 E 19TH AVE STE 500
DENVER CO
80218-1242
US

V. Phone/Fax

Practice location:
  • Phone: 303-762-3472
  • Fax:
Mailing address:
  • Phone: 303-762-3472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number38991
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: