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Individual

HEIDI WALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(720) 848-0000
Mailing address
PO BOX 876, AURORA, CO 80040-0876
(303) 493-7000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40791
CO
208M00000X
Hospitalist Physician
40791
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02709236
CO
Enumeration date
12/04/2006
Last updated
03/21/2011
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