MEDICARE: DR. RICHARD PATRICK PORRECO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VM0101X	Maternal & Fetal Medicine Physician	17769	CO

General Provider Information

NPI Number	:	1104889120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD PATRICK PORRECO M.D.

Provider Business Mailing Address
First Line	:	2055 HIGH ST STE 230
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-5503
Country	:	US
Telephone Number	:	303-839-7341
Fax Number	:	303-839-7360

Provider Business Practice Location Address
First Line	:	2055 HIGH ST STE 230
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-5503
Country	:	US
Telephone Number	:	303-839-7341
Fax Number	:	303-839-7360

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	10/15/2011

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