Provider Demographics
NPI:1235824145
Name:WOUTERS, COLTON REED (DO)
Entity Type:Individual
Prefix:DR
First Name:COLTON
Middle Name:REED
Last Name:WOUTERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29543 COUNTY ROAD 220
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:MO
Mailing Address - Zip Code:65732-7552
Mailing Address - Country:US
Mailing Address - Phone:417-399-2542
Mailing Address - Fax:
Practice Address - Street 1:ACADEMIC INTERNAL MEDICINE CLINIC
Practice Address - Street 2:5333 MCAULEY DRIVE, SUITE 4001
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-8633
Practice Address - Country:US
Practice Address - Phone:734-712-3980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program