Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OS013618 | PA |
Y | 207QS0010X | Family Doctor - Sports Medicine | 0055898 | CO |
N | 207QS0010X | Family Doctor - Sports Medicine | 259757 | MA |
NPI | 1194842484 |
---|---|
Provider Name | Dr. Tracy D Frombach |
First Address | Denver, CO 80205-5437 |
Second Address | Denver, CO 80205-5437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 04/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
026978 | KAISER COMMERCIAL NUMBER (01) | CO |
131562ZF11 | MEDICARE (01) | PA |
2053405 | HIGHMARK BS (01) | PA |
50097059 | CBC (01) | PA |
9783144 | AETNA (01) | PA |
P00962919 | RR MEDICARE (01) | PA |