Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 28546 | CO |
NPI | 1144364936 |
---|---|
Provider Name | Dr. Mark P De Marie |
First Address | Denver, CO 80205-5422 |
Second Address | Denver, CO 80205-5423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 08/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004570 | KAISER-COMMERCIAL NUMBER (01) | |
01285469 | (05) | CO |
F41786 | (02) | CO |