Brunvand, Mark Wilson

Brunvand, Mark Wilson is an individual health care provider with primary practice located at 1721 E 19Th Ave Ste 300, Denver CO 80218-1251. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Brunvand, Mark Wilson can be contacted via phone (720) 754-4800.

Contact Information

Primary practice address
1721 E 19Th Ave Ste 300 Denver CO 80218-1251
Phone: (720) 754-4800
Fax: (720) 754-4801
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 26243 Colorado

Profile Details

NPI number 1891779534
LBN Legal business name Brunvand, Mark Wilson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Feb 7th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891779534 NPPES
Wyoming MEDICAID 117831800
Wyoming MEDICAID 1891779534
Wyoming MEDICAID 200604790B
Wyoming MEDICAID 200604791B
Wyoming MEDICAID 37709003
Wyoming MEDICAID 01026244
Wyoming MEDICAID 10025893500

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