Healthcare Provider Details
I. General information
NPI: 1598788952
Provider Name (Legal Business Name): WILLIAM M SCELZA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/26/2006
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3425 S. CLARKSON
ENGLEWOOD CO
80113-2811
US
IV. Provider business mailing address
3425 S. CLARKSON
ENGLEWOOD CO
80113-2811
US
V. Phone/Fax
- Phone: 303-789-8220
- Fax: 303-789-8470
- Phone: 303-789-8220
- Fax: 303-789-8470
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | 2006-00265 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P0004X |
| Taxonomy | Spinal Cord Injury Medicine Physician |
| License Number | 2006-00265 |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | 50463 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: