Provider Demographics
NPI:1962408260
Name:BIFFL, WALTER L (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:L
Last Name:BIFFL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:MC 0206
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4507
Mailing Address - Country:US
Mailing Address - Phone:303-436-5842
Mailing Address - Fax:303-436-6572
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:MC 0206
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-5842
Practice Address - Fax:303-436-6572
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD0107892086S0127X
CO359252086S0127X, 2086S0102X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9023503Medicaid
G67141Medicare UPIN
RI9023503Medicaid