Provider Demographics
NPI:1861401150
Name:KALISH, WENDY A (MD)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:A
Last Name:KALISH
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 1:4350 WADSWORTH BLVD
Mailing Address - Street 2:#201
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4641
Mailing Address - Country:US
Mailing Address - Phone:720-898-9612
Mailing Address - Fax:720-898-9614
Practice Address - Street 1:4350 WADSWORTH BLVD
Practice Address - Street 2:#201
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4641
Practice Address - Country:US
Practice Address - Phone:720-898-9612
Practice Address - Fax:720-898-9614
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44493207R00000X
CODR.0044493208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57778825Medicaid