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General NPI Number Information
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NPI Number | 1215843784
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Entity Type | Individual
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Provider Name | MITCHELL WOLKOW
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Gender | Male
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 8401 S CHAMBERS RD
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City | ENGLEWOOD
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State | CO
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Zip | 80112-3276
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Country | US
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Telephone | 303-373-2008
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Fax |
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Provider Business Mailing Address
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Address Line | 9936 MELBOURNE CIR
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80130-8881
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CO
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