Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | DR0043324 | CO |
NPI | 1306881586 |
---|---|
Provider Name | Timothy J Pater |
First Address | Fort Collins, CO 80525-9718 |
Second Address | Longmont, CO 80503-6405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 11/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U24188 | (02) | CO |