Provider Demographics
NPI:1881685469
Name:DAUGHERTY, ROBIN SADKER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:SADKER
Last Name:DAUGHERTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-534-9550
Mailing Address - Fax:720-932-7805
Practice Address - Street 1:1515 WAZEE ST
Practice Address - Street 2:UNIT D
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1478
Practice Address - Country:US
Practice Address - Phone:303-534-9550
Practice Address - Fax:720-932-7805
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208780207R00000X
CO46128207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA105180Medicare PIN
COP01058174Medicare PIN