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NPI Code Detail

MEDICARE: PHILIP WALRAVENS MD

MEDICARE:   PHILIP  WALRAVENS  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
12080P0205XPediatric Endocrinology Physician17948CO

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 : 1629082946
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP WALRAVENS MD
Provider Business Mailing Address
First Line : PO BOX 876
Second Line :
City : AURORA
State : CO
Zip : 80040-0876
Country : US
Telephone Number : 303-493-7000
Fax Number :
Provider Business Practice Location Address
First Line : 1775 AURORA CT
Second Line :
City : AURORA
State : CO
Zip : 80045-2536
Country : US
Telephone Number : 720-724-2323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2006
Last Update Date : 01/04/2011

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Directions to “ PHILIP WALRAVENS MD” Practice Location

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