1881664944 NPI number — BRADLEY D VILIMS MD

Table of content: BRADLEY D VILIMS MD (NPI 1881664944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881664944 NPI number — BRADLEY D VILIMS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VILIMS
Provider First Name:
BRADLEY
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881664944
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 S YOSEMITE ST
Provider Second Line Business Mailing Address:
STE 330
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80237-1812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-268-4040
Provider Business Mailing Address Fax Number:
303-736-7147

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
325 TELLER ST
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80226-1606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-268-4040
Provider Business Practice Location Address Fax Number:
303-736-4147
Provider Enumeration Date:
01/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  39054 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0014X , with the licence number: 39054 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com