Provider Demographics
NPI:1174508923
Name:WINNEFELD, ANDREW WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WILLIAM
Last Name:WINNEFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1060 ORCHARD AVE UNIT H
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2997
Mailing Address - Country:US
Mailing Address - Phone:970-241-7600
Mailing Address - Fax:970-245-9094
Practice Address - Street 1:1060 ORCHARD AVE UNIT H
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2997
Practice Address - Country:US
Practice Address - Phone:970-241-7600
Practice Address - Fax:970-245-9094
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45254207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO8239843Medicaid
CO8239843Medicaid
CO807929Medicare PIN