Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 27299 | IA |
NPI | 1255497863 |
---|---|
Provider Name | Dr. Robert Austin Colman |
First Address | Des Moines, IA 50309-1410 |
Second Address | Des Moines, IA 50309-1410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0085225 | (05) | IA |
F27601 | (02) | IA |