Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 51000 | CO |
N | 207V00000X | Obstetrician & Gynecologist | MD195837 | OR |
N | 207VX0000X | Obstetrician | MD6099378 | WA |
NPI | 1376550731 |
---|---|
Provider Name | Dr. Patrick Scott Pevoto |
First Address | Grand Junction, CO 81505-1002 |
Second Address | Grand Junction, CO 81505-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 05/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
46686258 | (05) | CO |