Petrun, Mark
Petrun, Mark is an individual health care provider with primary practice located at 2121 E Harmony Rd Ste 300, Fort Collins CO 80528-3400. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Petrun, Mark can be contacted via phone (970) 224-9102.Contact Information
Primary practice address
2121 E Harmony Rd Ste 300
Fort Collins CO 80528-3400
Phone: (970) 224-9102
Fax: (970) 224-9112
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | DR.0024745 | Colorado |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | DR.0024745 | Colorado |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | DR.0024745 | Colorado |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | DR.0024745 | Colorado |
Profile Details
| NPI number | 1962472803 |
|---|---|
| LBN Legal business name | Petrun, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Aug 16th, 2016 - about 8 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 | 1962472803 | NPPES |
| Colorado | MEDICAID | 01247451 | |
| Colorado | MEDICAID | 104364100 | |
| Colorado | Other | 290007464 |
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