Provider Demographics
NPI:1639253156
Name:WILLIG, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:WILLIG
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 1:1421 S POTOMAC ST STE 210
Mailing Address - Street 2:SUITE 240
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4512
Mailing Address - Country:US
Mailing Address - Phone:303-923-3831
Mailing Address - Fax:
Practice Address - Street 1:3464 S WILLOW ST
Practice Address - Street 2:SUITE 853
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4531
Practice Address - Country:US
Practice Address - Phone:303-755-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COWI96971OtherBLUE SHIELD
CO01255462Medicaid
COWI96971OtherBLUE SHIELD
COD24653Medicare UPIN