Provider Demographics
NPI:1306895578
Name:MAIOCCO, ROBERT CLARKE (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLARKE
Last Name:MAIOCCO
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3025 S PARKER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2914
Mailing Address - Country:US
Mailing Address - Phone:720-981-9740
Mailing Address - Fax:720-981-9740
Practice Address - Street 1:3025 S PARKER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2914
Practice Address - Country:US
Practice Address - Phone:303-481-7030
Practice Address - Fax:303-745-7665
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2014-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO36651207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01366517Medicaid
COCOA108922Medicare PIN
COCO40581Medicare PIN
E11929Medicare UPIN