Provider Demographics
NPI:1427151877
Name:FAUVEL, MAURICE JUDE ROMEO (DO)
Entity type:Individual
Prefix:
First Name:MAURICE
Middle Name:JUDE ROMEO
Last Name:FAUVEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:159 HWY 72 W
Mailing Address - City:NEDERLAND
Mailing Address - State:CO
Mailing Address - Zip Code:80466-0550
Mailing Address - Country:US
Mailing Address - Phone:303-258-9355
Mailing Address - Fax:303-258-9356
Practice Address - Street 1:159 HWY 72 WEST
Practice Address - Street 2:POB 550
Practice Address - City:NEDERLAND
Practice Address - State:CO
Practice Address - Zip Code:80466
Practice Address - Country:US
Practice Address - Phone:303-258-9355
Practice Address - Fax:303-258-9356
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2010-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO35947207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA35947OtherSTATE LICENSE
1427151877OtherNPI
CO01359470Medicaid
CO01359470Medicaid
COC535288Medicare PIN