DAVID J. WIDHALM (NPI# 1154529790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154529790 |
| Entity Type | Individual |
| Full Name | DAVID J. WIDHALM |
| Practice Address |
1600 W 24th St Pueblo CO 81003-1411 |
| Practice Telephone | 7195464102 |
| Mailing Telephone | 7195464102 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
672 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1600 W 24TH ST |
| City | PUEBLO |
| State | CO |
| Zip Code | 81003-1411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427048917 | Lennart Rolf Abel | Psychiatry & Neurology | 1600 W 24th St, Pueblo, CO 81003-1411 | 2005-10-26 |
| 1306321294 | Cher Li Ang | Psychiatry & Neurology | 1600 W 24th St, Pueblo, CO 81003-1499 | 2018-09-26 |
| 1255815668 | Kalpana Narayanan Nair | Registered Nurse | 1600 W 24th St, Pueblo, CO 81003-1411 | 2018-09-21 |
| 1336651884 | Susan Oehler | Psychologist | 1600 W 24th St, Pueblo, CO 81003-1411 | 2017-10-24 |
| 1851831846 | Annabelle Florez | Nurse Practitioner | 1600 W 24th St, Pueblo, CO 81003-1411 | 2017-02-24 |
| 1114478245 | Miriam Suzanne Scott | Psychologist | 1600 W 24th St, Pueblo, CO 81003-1411 | 2016-10-24 |
| 1558746362 | Ryan Stanton Morris | Registered Nurse | 1600 W 24th St, Pueblo, CO 81003-1411 | 2015-07-22 |
| 1942691365 | Niesa Parmelee | Registered Nurse | 1600 W 24th St, Pueblo, CO 81003-1411 | 2015-02-06 |
| 1336547090 | Devona Marie Walter | Social Worker | 1600 W 24th St, Pueblo, CO 81003-1411 | 2014-12-11 |
| 1871918037 | Regan Young | Counselor | 1600 W 24th St, Pueblo, CO 81003-1411 | 2014-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042016 | Sunil Kumar | Student in an Organized Health Care Education/Training Program | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2020-04-21 |
| 1497382303 | Pueblo Family Dentistry Pllc | Dentist | 701 N Grand Avenue, Suite B, Pueblo, CO 81003 | 2020-03-23 |
| 1023654241 | Elmer A. Villalon, Dmd, LLC | Clinic/Center | 1225 North Main Street, #207, Pueblo, CO 81003 | 2019-11-22 |
| 1518434349 | Mariam Rahim | Internal Medicine | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-10-30 |
| 1003308222 | Julia Mcneice | Internal Medicine | Parkview Medial Center, Parkveiw Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-06-04 |
| 1689164857 | Jessica Sels | Internal Medicine | Parkview Medical Center Adult Medicine Clinic, 311 W 14th St, Pueblo, CO 81003 | 2018-05-14 |
| 1700313459 | Allison Vigil | Occupational Therapist | 1600 W. 24th St, Pueblo, CO 81003 | 2017-05-12 |
| 1245682020 | Paul S Bongat | Internal Medicine | 411 W. 14th St., Parkview Adult Medicine Clinic, Pueblo, CO 81003 | 2016-07-06 |
| 1013368596 | Daniel R Long | Internal Medicine | 411 West 14th Street, Pueblo, CO 81003 | 2016-06-27 |
| 1396195665 | Parkview Medical Center | General Acute Care Hospital | 411 W. 14th St, Pueblo, CO 81003 | 2016-06-17 |
| Find all providers in zip 81003 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578129839 | Jodell C Sams Crnfa, LLC | Physician Assistant | 2911 Country Club Dr, Pueblo, CO 81008-1202 | 2019-05-13 |
| 1245896778 | Professional Associates of Surgical Services Inc. | Physician Assistant | 3136 Bighorn Ct, Pueblo, CO 81005-4016 | 2019-05-09 |
| 1114397437 | Andrew Christopher Glass | Physician Assistant | 1600 North Grand Ave., Suite 508, Pueblo, CO 81003-2757 | 2015-09-29 |
| 1285889154 | Mark Neal Rice | Physician Assistant | 3676 Parker Blvd, Suite 110, Pueblo, CO 81008-2212 | 2008-11-19 |
| 1750473526 | Franklin Peter Sloan Jr. | Physician Assistant | 3530 Spaulding Ave, Pueblo, CO 81008-2209 | 2006-09-29 |
| 1528039245 | Robert W. Simmons | Physician Assistant | 4112 Outlook Blvd, Suite 37, Pueblo, CO 81008-1667 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033737366 | Wound Solutions Inc | Physician Assistant | 130 Old Laramie Trl Ste 100, Lafayette, CO 80026-7014 | 2020-07-13 |
| 1295396513 | Joseph D Timmermeyer | Physician Assistant | 324 Fossil Dr, Johnstown, CO 80534-7452 | 2019-06-26 |
| 1356805626 | Heather Free | Physician Assistant | 3653 N Josephine St, Denver, CO 80205-3545 | 2019-01-30 |
| 1255804910 | Jessie P Larson | Physician Assistant | 7847 Downing St, Denver, CO 80229-5961 | 2019-01-05 |
| 1710453543 | Lindsay Marie Bergman | Physician Assistant | 1140 Edwards Village II, B-105, Edwards, CO 81632 | 2018-10-19 |
| 1225533136 | Rafael Eduardo Castillo | Physician Assistant | 6200 Habitat Dr Apt 2052, Boulder, CO 80301-3235 | 2018-03-25 |
| 1972026276 | Sophia Jane Wagner | Physician Assistant | 2643 Patterson Rd Ste 403, Grand Junction, CO 81506-1937 | 2017-07-19 |
| 1326588732 | Elise Nicole Van Etten | Physician Assistant | 13123 E 16th Ave # 323, Anschutz Medical Campus, Aurora, CO 80045-7106 | 2017-03-03 |
| 1336691914 | Patrick Craig Ford | Physician Assistant | 6500 29th St Ste 106, Greeley, CO 80634-8386 | 2016-10-28 |
| 1942751904 | 5280 Surgical Assisting Professional LLC | Physician Assistant | 10233 Bluffmont Dr, Lone Tree, CO 80124-5559 | 2016-10-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DAVID J. WIDHALM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.