Provider Demographics
NPI:1225026362
Name:MCGRATH, ROBERT (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1810 E 3RD AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5025
Mailing Address - Country:US
Mailing Address - Phone:970-247-4567
Mailing Address - Fax:970-533-7310
Practice Address - Street 1:1810 E 3RD AVE
Practice Address - Street 2:STE 101
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5025
Practice Address - Country:US
Practice Address - Phone:970-247-4567
Practice Address - Fax:970-533-7310
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO18835208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84070694583OtherPACIFICARE
COMCR17483OtherANTHEM BCBS
201006576OtherPRESBYTERIAN HEALTH PLAN
T0658OtherMEDICAID OF UTAH
Y4632OtherNEW MEXICO MEDICAID
NM00998OtherBCBS OF NEW MEXICO
370018626OtherTRAVELERS MEDICARE
CO01188358Medicaid
CO84070694587OtherROCKY MOUNTAIN HEALTH PLA
CO84070694587OtherROCKY MOUNTAIN HEALTH PLA
CO01188358Medicaid