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Individual

MAURICE JUDE ROMEO FAUVEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
159 HWY 72 WEST, POB 550, NEDERLAND, CO 80466
(303) 258-9355
(303) 258-9356
Mailing address
PO BOX 550, 159 HWY 72 W, NEDERLAND, CO 80466-0550
(303) 258-9355
(303) 258-9356

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35947
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01359470
CO
01
1427151877
NPI
01
35947
STATE LICENSE
CA
Enumeration date
09/07/2006
Last updated
02/13/2010
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