Provider Demographics
NPI:1194719351
Name:VILLAVERT, MARIA A (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:VILLAVERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8601 TURNPIKE DR UNIT 200
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7044
Mailing Address - Country:US
Mailing Address - Phone:303-428-7449
Mailing Address - Fax:303-487-5196
Practice Address - Street 1:8601 TURNPIKE DR UNIT 200
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-7044
Practice Address - Country:US
Practice Address - Phone:303-428-7449
Practice Address - Fax:303-487-5196
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO43886207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90507363Medicaid
COCO303679Medicare PIN
COC495158Medicare PIN
CO90507363Medicaid