=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992876528
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT D MAURO MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6931 S PIERCE ST
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-973-3200
-----------------------------------------------------
Fax | 303-904-8510
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9094 E MINERAL AVE
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-694-3200
-----------------------------------------------------
Fax | 303-694-2680
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 23284
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------