Provider Demographics
NPI:1205945813
Name:ROUNTREE, ROBERT COLLINS (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:COLLINS
Last Name:ROUNTREE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:75 MANHATTAN DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-4254
Mailing Address - Country:US
Mailing Address - Phone:303-443-9590
Mailing Address - Fax:303-443-9787
Practice Address - Street 1:75 MANHATTAN DR
Practice Address - Street 2:SUITE1
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-4254
Practice Address - Country:US
Practice Address - Phone:303-443-9590
Practice Address - Fax:303-443-9787
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2011-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO25579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD24660Medicare UPIN