Provider Demographics
NPI:1336638501
Name:JUBAIR, WIDIAN (MD)
Entity type:Individual
Prefix:
First Name:WIDIAN
Middle Name:
Last Name:JUBAIR
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 1:20991 E SMOKY HILL RD STE 150
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5184
Mailing Address - Country:US
Mailing Address - Phone:720-975-8044
Mailing Address - Fax:833-974-3861
Practice Address - Street 1:20991 E SMOKY HILL RD STE 150
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5184
Practice Address - Country:US
Practice Address - Phone:720-975-8044
Practice Address - Fax:833-974-3861
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0067057207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine