Provider Demographics
NPI:1871534941
Name:ZIEG, DAVID A (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:ZIEG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12257 S WADSWORTH BLVD
Mailing Address - Street 2:MAIL STOP 1398
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-8504
Mailing Address - Country:US
Mailing Address - Phone:303-977-7879
Mailing Address - Fax:303-971-5774
Practice Address - Street 1:12257 S WADSWORTH BLVD
Practice Address - Street 2:MAIL STOP 1398
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80125-8504
Practice Address - Country:US
Practice Address - Phone:303-977-7879
Practice Address - Fax:303-971-5774
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO39479207Q00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10025065Medicaid
COC452558Medicare PIN
CO10025065Medicaid