Healthcare Provider Details

I. General information

NPI: 1831282508
Provider Name (Legal Business Name): DAVID WOODBURNE WELLS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4143 S JULIAN WAY
DENVER CO
80236-3101
US

IV. Provider business mailing address

8284 N SUNBURST TRL
PARKER CO
80134-6920
US

V. Phone/Fax

Practice location:
  • Phone: 303-866-7339
  • Fax: 303-866-7383
Mailing address:
  • Phone: 303-841-3888
  • Fax: 303-866-7383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number21876
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: