Individual
TAISA VICTORIA WIEDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
835 E 18TH AVE STE 110, DENVER, CO 80218-1024
(303) 825-4646
(303) 825-3215
Mailing address
835 E 18TH AVE STE 110, DENVER, CO 80218-1024
(303) 825-4646
(303) 825-3215
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
56332
CO
208M00000X
Hospitalist Physician
Primary
56332
CO
Other
Enumeration date
04/18/2014
Last updated
07/21/2022
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