Individual
DR. BRENT WIELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3885 UPHAM ST, STE 200, WHEAT RIDGE, CO 80033-4880
(303) 425-9245
(303) 425-1378
Mailing address
PO BOX 1449, WHEAT RIDGE, CO 80034-1449
(303) 425-9245
(303) 425-1378
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
50083
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25986864
—
CO
Enumeration date
02/14/2007
Last updated
02/17/2020
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