Doctor Name: | MICHAEL S WISNIEWSKI |
NPI Number: | 1346452414 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 1353 |
Business Practice Address: | 8300 W 38th Ave Wheat Ridge, CO - 800336005 |
Business Phone Number: | 8668997136 |
Business Fax Number: | |
Mailing Address: | Dept 1265, DENVER |
State: | CO |
Postal Code: | 802560001 |
Phone Number: | 3036894444 |
Fax Number: | |
NPI Enumeration Date: | 05/03/2007 |
NPI Last Update Date: | 11/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 1353 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |