Individual
DR. FABIO B PIVETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2345 BENT WAY, LONGMONT, CO 80503-7614
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(390) 338-3382
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39838
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027765
KAISER COMMERCIAL NUMBER
CO
01
—
04003158
MEDICAID - LUH PROF
CO
01
—
05003009
MEDICAID - HOSPITAL
CO
05
—
97434841
—
CO
Enumeration date
05/18/2007
Last updated
03/29/2021
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