Menich, Mark David

Menich, Mark David is an sole proprietor health care provider with primary practice located at 3950 Broadway St Boulder Valley Asthma And Allergy Clinics, Boulder CO 80304-1104. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Allergy & Immunology. Allopathic & Osteopathic Physicians / Allergy is his primary health care specialty. Menich, Mark David can be contacted via phone (303) 444-5995.

Contact Information

Primary practice address
3950 Broadway St Boulder Valley Asthma And Allergy Clinics Boulder CO 80304-1104
Phone: (303) 444-5995
Fax: (303) 443-5030
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy 207KA0200X 46383 Colorado
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 46383 Colorado
Allopathic & Osteopathic Physicians / Allergy & Immunology 207RA0201X MD044657E Pennsylvania

Profile Details

NPI number 1417983438
LBN Legal business name Menich, Mark David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2006
Last updated Dec 30th, 2015 - about 9 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 1417983438 NPPES
Colorado MEDICAID 14209764

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