Healthcare Provider Details

I. General information

NPI: 1477550960
Provider Name (Legal Business Name): ROBERT R FIERER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 02/10/2023
Certification Date: 02/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10050 RALSTON RD # 1 - B/E
NORTHGLENN CO
80233-4974
US

IV. Provider business mailing address

11857 KEOUGH DR
NORTHGLENN CO
80233-1221
US

V. Phone/Fax

Practice location:
  • Phone: 720-401-2340
  • Fax:
Mailing address:
  • Phone: 720-401-2340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0049839
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD035627L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberDR.0049839
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberAF6214960
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: