Healthcare Provider Details

I. General information

NPI: 1558396614
Provider Name (Legal Business Name): ROBERT P. DOLAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BUCK CREEK RD STE 200
AVON CO
81620-5428
US

IV. Provider business mailing address

382 S ARTHUR AVE
LOUISVILLE CO
80027-3094
US

V. Phone/Fax

Practice location:
  • Phone: 970-926-6340
  • Fax: 970-926-6348
Mailing address:
  • Phone: 303-604-5000
  • Fax: 720-890-0364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number31417
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: