Provider Demographics
NPI:1245233782
Name:WITTEN, DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:WITTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 E 9TH AVE
Mailing Address - Street 2:STE 140
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3920
Mailing Address - Country:US
Mailing Address - Phone:303-394-2152
Mailing Address - Fax:303-394-2496
Practice Address - Street 1:4500 E 9TH AVE
Practice Address - Street 2:STE 140
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3920
Practice Address - Country:US
Practice Address - Phone:303-394-2152
Practice Address - Fax:303-394-2496
Is Sole Proprietor?:No
Enumeration Date:2005-05-28
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40778207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28482379Medicaid
503848Medicare ID - Type Unspecified
CO28482379Medicaid