Individual
DR. JERRELL WAIKA HEROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10103 RIDGEGATE PKWY STE 103, LONE TREE, CO 80124-5524
(303) 645-0090
(303) 645-0092
Mailing address
4900 S MONACO ST STE 210, DENVER, CO 80237-3487
(303) 645-0090
(303) 645-0092
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
53179
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45979847
—
CO
Enumeration date
05/05/2008
Last updated
01/13/2022
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