Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | H-D-1-05391 | CO |
Y | 213EG0000X | General Practice | H-D-1-05391 | CO |
NPI | 1003841586 |
---|---|
Provider Name | Mark F Ugai |
First Address | Durango, CO 81301-5475 |
Second Address | Durango, CO 81301-5475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |