MEDICARE: DR. DAVID WOODBURNE WELLS M.D.

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
1	2080A0000X	Pediatric Adolescent Medicine Physician	21876	CO

Other Identifiers

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

General Provider Information

NPI Number	:	1831282508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID WOODBURNE WELLS M.D.

Provider Business Mailing Address
First Line	:	8284 N SUNBURST TRL
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-6920
Country	:	US
Telephone Number	:	303-841-3888
Fax Number	:	303-866-7383

Provider Business Practice Location Address
First Line	:	4143 S JULIAN WAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80236-3101
Country	:	US
Telephone Number	:	303-866-7339
Fax Number	:	303-866-7383

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/09/2007

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