Individual
DR. JEREMY DEWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, NREMT-P
Contact information
Practice address
16420 W US HIGHWAY 24, WOODLAND PARK, CO 80863
(719) 687-9999
(303) 306-7753
Mailing address
PO BOX 173891, DENVER, CO 80217-3891
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2365-850
WI
207P00000X
Emergency Medicine Physician
Primary
48580
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30489377
—
CO
Enumeration date
03/28/2007
Last updated
11/06/2019
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