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General NPI Number Information
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NPI Number | 1982877494
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Entity Type | Organization
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Legal Business Name | ALLERGY, ASTHMA & IMMUNOLOGY OF THE ROCKIES, PC
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Dates
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Enumeration Date | 04/04/2008
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 1810 GRAND AVE
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-4112
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Country | US
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Telephone | 970-947-0600
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Fax | 970-947-0601
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Provider Business Mailing Address
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Address Line | PO BOX #2601
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City | GLENWOOD SPINGS
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State | CO
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Zip | 81602-2601
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Country | US
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Telephone | 970-947-0600
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Fax | 970-947-0601
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Authorized Official
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Title or Position | PHYSICIAN OWNER/PRESIDENT
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Name | ROBERT A. MCDERMOTT
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Credential | MD
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Telephone | 970-947-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 41037
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License Number State | CO
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