Provider Demographics
NPI:1881664944
Name:VILIMS, BRADLEY D (MD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:D
Last Name:VILIMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3600 S YOSEMITE ST
Mailing Address - Street 2:STE 330
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1812
Mailing Address - Country:US
Mailing Address - Phone:303-268-4040
Mailing Address - Fax:303-736-7147
Practice Address - Street 1:325 TELLER ST
Practice Address - Street 2:SUITE 240
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1606
Practice Address - Country:US
Practice Address - Phone:303-268-4040
Practice Address - Fax:303-736-4147
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2007-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO39054207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYW21349Medicare PIN
COE86964Medicare UPIN
COC802449Medicare PIN