Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 38117 | CO |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 38117 | CO |
NPI | 1356370191 |
---|---|
Provider Name | Dr. Mark Sarinopoulos |
First Address | Louisville, CO 80027-2234 |
Second Address | Broomfield, CO 80020-2090 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 17/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
75129728 | (05) | CO |
H95836 | (02) | CO |
SA549988 | BC/BS (01) | CO |