Provider Demographics
NPI:1457454472
Name:FLIEGE, HEATHER LEANNE (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEANNE
Last Name:FLIEGE
Suffix:
Gender:F
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:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80038-0327
Mailing Address - Country:US
Mailing Address - Phone:303-543-9504
Mailing Address - Fax:303-543-9729
Practice Address - Street 1:308 W BASELINE RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-1719
Practice Address - Country:US
Practice Address - Phone:303-543-9504
Practice Address - Fax:303-543-9729
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34786207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine