Provider Demographics
NPI:1811910383
Name:BEIN, ROBERT HOLLOWAY (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HOLLOWAY
Last Name:BEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5412 IDYLWILD TRL STE 105
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3806
Mailing Address - Country:US
Mailing Address - Phone:303-938-9284
Mailing Address - Fax:720-652-0408
Practice Address - Street 1:5412 IDYLWILD TRL STE 105
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3806
Practice Address - Country:US
Practice Address - Phone:303-938-9284
Practice Address - Fax:720-652-0408
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO307312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01307313Medicaid
C23449Medicare ID - Type Unspecified
CO01307313Medicaid