Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | DR.0048596 | CO |
NPI | 1144377037 |
---|---|
Provider Name | Ryan L Hartman |
First Address | Fort Collins, CO 80525-9773 |
Second Address | Fort Collins, CO 80525-9718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 16/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1144377037 | (05) | WY |
32934521 | (05) | CO |
P00898194 | RR MEDICARE (01) | CO |