Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | DR.0033914 | CO |
N | 207RP1001X | Pulmonary Disease | 33914 | CO |
NPI | 1962592642 |
---|---|
Provider Name | Andrew Fontenot |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 16/04/2021 |