Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | DR.0056036 | CO |
N | 2080N0001X | Neonatal-Perinatal Doctor | 036106127 | IL |
NPI | 1003966045 |
---|---|
Provider Name | Dr. Michael R Hobaugh |
First Address | Fort Collins, CO 80525 |
Second Address | Fort Collins, CO 80525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 27/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036106127 | (05) | IL |