Provider Demographics
NPI:1316989122
Name:WOLLSCHLAEGER, KARIN (MD)
Entity type:Individual
Prefix:DR
First Name:KARIN
Middle Name:
Last Name:WOLLSCHLAEGER
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 1:1960 N OGDEN ST
Mailing Address - Street 2:#340
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218
Mailing Address - Country:US
Mailing Address - Phone:303-318-3830
Mailing Address - Fax:303-318-3825
Practice Address - Street 1:1960 N OGDEN ST
Practice Address - Street 2:SUITE 340
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218
Practice Address - Country:US
Practice Address - Phone:303-318-3830
Practice Address - Fax:303-318-3825
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224595174400000X
CO49617207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO34455078Medicaid
NYH68919Medicare UPIN
CO34455078Medicaid