Organization Name: | PEDIATRIC AND ADOLESCENT MEDICINE ASSOCIATES PC |
NPI Number: | 1043633647 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID B. ROOS (PRESIDENTT) |
Mailing Address: | 9235 Crown Crest Blvd Suite 100 Parker |
State: | CO US |
Postal Code: | 801388880 |
Phone Number: | 3036957667 |
Fax Number: | 3036958146 |
NPI Enumeration Date: | 02/03/2014 |
NPI Last Update Date: | 02/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |