Individual
ROBERT D UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1245
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08124596
—
CO
01
—
3444
BLUE CROSS BLUE SHIELD
CO
Enumeration date
07/18/2006
Last updated
11/03/2011
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