Organization
PEDIATRICS 5280 PC
Active
Other names
Pediatrics DTC PC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HOLBROOK STAPP MD (PRESIDENT PHYSICIAN)
(303) 779-5437
Entity
Organization
Contact information
Practice address
9094 E MINERAL AVE, SUITE 120, CENTENNIAL, CO 80112-7200
(303) 779-5437
(303) 689-9628
Mailing address
9094 E MINERAL AVE, SUITE 120, CENTENNIAL, CO 80112-7200
(303) 779-5437
(303) 689-9628
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4013280
—
CO
Enumeration date
04/05/2006
Last updated
07/08/2008
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