Provider Demographics
NPI:1942373071
Name:WERNER, DREW (MD)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:WERNER
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 1:831 S PERRY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1919
Mailing Address - Country:US
Mailing Address - Phone:303-218-7774
Mailing Address - Fax:303-805-7732
Practice Address - Street 1:831 S PERRY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1919
Practice Address - Country:US
Practice Address - Phone:303-218-7774
Practice Address - Fax:303-805-7732
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO38541207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO99532034Medicaid
CO1942373071OtherNPI
COCO38541OtherLICENSE
CO1942373071OtherNPI
COC443718Medicare PIN