Provider Demographics
NPI:1306374236
Name:LIEWEN, ALISON PAIGE (MD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:PAIGE
Last Name:LIEWEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 S MASON ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3740
Mailing Address - Country:US
Mailing Address - Phone:970-266-3629
Mailing Address - Fax:
Practice Address - Street 1:4601 S MASON ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3740
Practice Address - Country:US
Practice Address - Phone:970-266-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA170692207Q00000X
CODR.0072561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine