Provider Demographics
NPI:1265405930
Name:VELLMAN, W PETER (MD)
Entity type:Individual
Prefix:
First Name:W
Middle Name:PETER
Last Name:VELLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:P
Other - Last Name:VELLMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5788
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5788
Mailing Address - Country:US
Mailing Address - Phone:303-202-1280
Mailing Address - Fax:303-202-1281
Practice Address - Street 1:11600 W 2ND PL
Practice Address - Street 2:ST. ANTHONY HOSPITAL, EMERGENCY DEPT.
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1527
Practice Address - Country:US
Practice Address - Phone:720-321-4161
Practice Address - Fax:720-321-4165
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24110207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEPENDINGMedicaid
UTZ3272Medicaid
203206023101OtherPACIFICARE SECURE HORIZONS
WY122713100Medicaid
610854400OtherUS DEPARTMENT OF LABOR
P00181908OtherRR MEDICARE
AZ129035Medicaid
KS200390020AMedicaid
CO01241108Medicaid
NMS2054Medicaid
NEPENDINGMedicaid
WY122713100Medicaid