Healthcare Provider Details

I. General information

NPI: 1801814009
Provider Name (Legal Business Name): DAVID WILLIAM SCHALLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 CENTRAL PARK DRIVE #209
STEAMBOAT SPRINGS CO
80487
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-3738
  • Fax: 970-870-6441
Mailing address:
  • Phone: 970-624-4128
  • Fax: 970-490-4340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number31461
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: