Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 26460 | CO |
Y | 2080P0201X | Pediatric Allergist | DR.0026460 | CO |
NPI | 1508877374 |
---|---|
Provider Name | Dr. Fred Mcdaniel Atkins |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 05/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01264605 | (05) | CO |
E71661 | (02) | CO |