Doctor Name: | RICHARD A MOUCHANTAT |
NPI Number: | 1013937390 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 33783 |
Business Practice Address: | 3280 Wadsworth Blvd Suite 100 Wheat Ridge, CO - 800334628 |
Business Phone Number: | 3032328585 |
Business Fax Number: | 3032323304 |
Mailing Address: | 3280 Wadsworth Blvd, Suite 100 WHEAT RIDGE |
State: | CO |
Postal Code: | 800334628 |
Phone Number: | 3032328585 |
Fax Number: | 3032323304 |
NPI Enumeration Date: | 07/20/2006 |
NPI Last Update Date: | 09/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 33783 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |