Provider Demographics
NPI:1710159942
Name:HEPPE, DANIEL BRUCE (MD)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:BRUCE
Last Name:HEPPE
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 1:629 CLARKSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3201
Mailing Address - Country:US
Mailing Address - Phone:720-771-0667
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF COLORADO SCHOOL OF MEDICINE
Practice Address - Street 2:4200 E 9TH AVE
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80262-0001
Practice Address - Country:US
Practice Address - Phone:303-315-7424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CO49874207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program