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General NPI Number Information
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NPI Number | 1093911182
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Entity Type | Organization
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Legal Business Name | HEATHER L. FLIEGE, M.D., P.C.
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 11/20/2007
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Provider Practice Location Address
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Address Line | 308 W BASELINE RD
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City | LAFAYETTE
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State | CO
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Zip | 80026-1719
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Country | US
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Telephone | 303-543-9504
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Fax | 303-543-9729
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Provider Business Mailing Address
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Address Line | PO BOX 327
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City | BROOMFIELD
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State | CO
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Zip | 80038-0327
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Country | US
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Telephone | 303-543-9504
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Fax | 303-543-9729
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HEATHER LEANNE FLIEGE
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Credential | M.D.
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Telephone | 303-543-9504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34786
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License Number State | CO
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