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DR. ROBERT TODD MICHAEL DO

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1053523753

Individual Registrant:
DR. ROBERT TODD MICHAEL DO
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1211 LUTHER STREET  EADS, CO 80136 US
Tel: 719-438-2251  Fax: 719-438-2254

Contact information for business:
6125 HABITAT DR APT 1082  BOULDER, CO 80301-3227 US
Tel: 303-818-8859  Fax: 719-438-2254

Registration Information:
NPI: 1053523753
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CO34288

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
64022056CO05




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