Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 39885 | CO |
NPI | 1013117092 |
---|---|
Provider Name | Eric Richter |
First Address | Denver, CO 80256-0825 |
Second Address | Pueblo, CO 81001-1046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 07/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
76650839 | (05) | CO |