Mark Andrew Wisner D.O.

NPI 1083829162 - Family Medicine - 207Q00000X

NPI Details
NPI 1083829162
Gender Male
Enumeration Date 05/11/2007
Last Updated 11/10/2009
Entity Type Individual
Active Over 9 years ago
Practice Location
5330 MANHATTAN CIR
SUITE C-2
BOULDER CO, 80303-4240, US
Phone (303) 543-1111
Fax (303) 543-1112
Business Location
5330 MANHATTAN CIR
SUITE C-2
BOULDER CO, 80303-4240, US
Phone (303) 543-1111
Fax (303) 543-1112
Toxanomy
Taxonomy Code 207Q00000X
License State Colorado
License Number CO 44052
Remove 1083829162 NPI Number
 

According to our database, Dr. Mark Andrew Wisner D.O. NPI is 1083829162, taxonomy code is 207Q00000X and license number is CO 44052, license state is located at Colorado. Mark Andrew Wisner D.O. physically located at 5330 Manhattan Cir, Boulder CO, 80303-4240. NPI Number Mark Andrew Wisner D.O. has the Individual type.

Sponsored links

1083829162 NPI number is provided on an as is basis without warranty of any kind. 1083829162 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Andrew Wisner D.O. are for informational purposes only.