Healthcare Provider Details

I. General information

NPI: 1770700544
Provider Name (Legal Business Name): REPRODUCTIVE MEDICINE & FERTILITY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 INTERNATIONAL CIR SUITE 100
COLORADO SPRINGS CO
80910-3161
US

IV. Provider business mailing address

3225 INTERNATIONAL CIR SUITE 100
COLORADO SPRINGS CO
80910-3161
US

V. Phone/Fax

Practice location:
  • Phone: 719-475-2229
  • Fax: 719-475-2227
Mailing address:
  • Phone: 719-475-2229
  • Fax: 719-475-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number44858
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number36345
License Number StateCO

VIII. Authorized Official

Name: MEL COHEN
Title or Position: EXECUTIVE DIRECTER
Credential:
Phone: 719-475-2229