Healthcare Provider Details

I. General information

NPI: 1093324659
Provider Name (Legal Business Name): DISPATCHHEALTH ADVANCED CARE - WASHINGTON PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 RINGSBY CT STE 102
DENVER CO
80216-4923
US

IV. Provider business mailing address

3455 RINGSBY CT STE 102
DENVER CO
80216-4923
US

V. Phone/Fax

Practice location:
  • Phone: 303-500-1518
  • Fax:
Mailing address:
  • Phone: 303-500-1518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW WAGNER
Title or Position: CMO
Credential: MD
Phone: 303-500-1518