Healthcare Provider Details

I. General information

NPI: 1922142629
Provider Name (Legal Business Name): ROBERT S MCDUFFIE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 N OGDEN ST SUITE 330
DENVER CO
80218-3666
US

IV. Provider business mailing address

1960 N OGDEN ST SUITE 330
DENVER CO
80218-3666
US

V. Phone/Fax

Practice location:
  • Phone: 303-318-2610
  • Fax: 303-318-2619
Mailing address:
  • Phone: 303-318-2610
  • Fax: 303-318-2619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number24966
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: