Provider Demographics
NPI:1629030606
Name:SOWELL, HEATHER EILEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:EILEEN
Last Name:SOWELL
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 1:1780 S BELLAIRE ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4330
Mailing Address - Country:US
Mailing Address - Phone:303-789-4949
Mailing Address - Fax:303-789-7495
Practice Address - Street 1:1780 S BELLAIRE ST
Practice Address - Street 2:SUITE 700
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4330
Practice Address - Country:US
Practice Address - Phone:303-789-4949
Practice Address - Fax:303-789-7495
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31993207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF93651Medicare UPIN