Provider Demographics
NPI:1427011584
Name:WILK, JAMES SHEAHAN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SHEAHAN
Last Name:WILK
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 1:311 STEELE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4479
Mailing Address - Country:US
Mailing Address - Phone:303-372-4000
Mailing Address - Fax:303-372-4001
Practice Address - Street 1:311 STEELE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4479
Practice Address - Country:US
Practice Address - Phone:303-372-4000
Practice Address - Fax:303-372-4001
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33021207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01330216Medicaid
CO01330216Medicaid
COG01548Medicare UPIN