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NPI Code Detail

MEDICARE: DR. WADE HEINRICHS MD

MEDICARE: DR. WADE HEINRICHS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician42312CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174528400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WADE HEINRICHS MD
Provider Business Mailing Address
First Line : 11083 COLORADO BLVD
Second Line :
City : FIRESTONE
State : CO
Zip : 80504
Country : US
Telephone Number : 303-833-8880
Fax Number : 720-494-3107
Provider Business Practice Location Address
First Line : 11083 COLORADO BLVD
Second Line :
City : FIRESTONE
State : CO
Zip : 80504-5873
Country : US
Telephone Number : 303-833-8880
Fax Number : 720-494-3107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 06/15/2017

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Directions to “ DR. WADE HEINRICHS MD” Practice Location

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