Provider Demographics
NPI:1821181199
Name:TEAFORD, ANDREW WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WAYNE
Last Name:TEAFORD
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 1:3400 LUTHERAN PKWY
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6035
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 LUTHERAN PKWY
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6035
Practice Address - Country:US
Practice Address - Phone:303-467-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO395382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47988851Medicaid
CO47988851Medicaid