| Pediatrics 5280 PC | |
|
9094 E Mineral Ave Suite 120 Centennial CO 80112-7200 | |
| (303) 779-5437 | |
| (303) 689-9628 |
| Full Name | Pediatrics 5280 PC |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 9094 E Mineral Ave, Centennial, Colorado |
| Authorized Official Name and Position | Robert Holbrook Stapp (PRESIDENT PHYSICIAN) |
| Authorized Official Contact | 3037795437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatrics 5280 PC 9094 E Mineral Ave Suite 120 Centennial CO 80112-7200 Ph: (303) 779-5437 | Pediatrics 5280 PC 9094 E Mineral Ave Suite 120 Centennial CO 80112-7200 Ph: (303) 779-5437 |
| NPI Number | 1629030689 |
|---|---|
| Provider Enumeration Date | 04/05/2006 |
| Last Update Date | 07/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629030689 | NPI | - | NPPES |
| 4013280 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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