Provider Demographics
NPI:1780659870
Name:BLAYNEY, ROBERT LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:BLAYNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1537 W DRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4496
Mailing Address - Country:US
Mailing Address - Phone:303-347-8376
Mailing Address - Fax:303-979-7949
Practice Address - Street 1:8370 W COAMINE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123
Practice Address - Country:US
Practice Address - Phone:303-972-4017
Practice Address - Fax:303-979-7949
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO24896207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD24537Medicare UPIN
CO1040-1Medicare ID - Type Unspecified