Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 51038 | CO |
NPI | 1952311284 |
---|---|
Provider Name | Dr. Christopher Pell Fender |
First Address | Golden, CO 80401-2263 |
Second Address | Golden, CO 80401-2263 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 17/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2347815 | MEDICARE (01) | NC |
5914116 | (05) | NC |