Healthcare Provider Details

I. General information

NPI: 1710159942
Provider Name (Legal Business Name): DANIEL BRUCE HEPPE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 06/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF COLORADO SCHOOL OF MEDICINE 4200 E 9TH AVE
DENVER CO
80262-0001
US

IV. Provider business mailing address

629 CLARKSON ST
DENVER CO
80218-3201
US

V. Phone/Fax

Practice location:
  • Phone: 303-315-7424
  • Fax:
Mailing address:
  • Phone: 720-771-0667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number49874
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: