Provider Demographics
NPI:1912994435
Name:FELL, WILLIAM F (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:FELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5784 S KITTREDGE ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-4004
Mailing Address - Country:US
Mailing Address - Phone:303-693-3279
Mailing Address - Fax:
Practice Address - Street 1:1421 S POTOMAC ST
Practice Address - Street 2:SUITE 220
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4535
Practice Address - Country:US
Practice Address - Phone:303-872-3914
Practice Address - Fax:720-535-4832
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17471207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01174713Medicaid
CO358518YL7XMedicare PIN