Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 45511 | CO |
NPI | 1073590782 |
---|---|
Provider Name | Maurice Markus |
First Address | Greenwood Village, CO 80111 |
Second Address | Colorado Springs, CO 80907-5320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2005 |
Last Update Date | 21/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
70221324 | (05) | CO |
BM8874009 | DEA (01) | |
I15875 | (02) |