Individual
TANIOS JOSEPH WANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4567 E 9TH AVE, DENVER, CO 80220-3908
(303) 320-2455
(303) 306-7753
Mailing address
PO BOX 173862, DENVER, CO 80217-3862
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0055093
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67029264
—
CO
Enumeration date
05/10/2012
Last updated
07/28/2015
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