Doctor Name: | DR. TERESA REBIBO FOX |
NPI Number: | 1871735381 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 41031 |
Business Practice Address: | 4840 Riverbend Rd 100 Boulder, CO - 803012659 |
Business Phone Number: | 3036014222 |
Business Fax Number: | |
Mailing Address: | 4840 Riverbend Rd, 100 BOULDER |
State: | CO |
Postal Code: | 803012659 |
Phone Number: | 3036014222 |
Fax Number: | |
NPI Enumeration Date: | 03/30/2009 |
NPI Last Update Date: | 01/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 41031 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |