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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417983438 | NPPES |
| Colorado | MEDICAID | 14209764 |
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