Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 48850 | CO |
NPI | 1245377522 |
---|---|
Provider Name | Robin Maccoll Fennimore |
First Address | Denver, CO 80220-3911 |
Second Address | Denver, CO 80220-3911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 09/12/2010 |