Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 18384 | CO |
NPI | 1033252580 |
---|---|
Provider Name | Dr. Stephen J Mohr |
First Address | Avon, CO 81620-4330 |
Second Address | Avon, CO 81620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 05/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002473 | KAISER-COMMERCIAL NUMBER (01) | |
01183847 | (05) | CO |
E85553 | (02) | CO |