MEDICARE: MARK BENJAMIN ZAMBONI-CUTTER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	5101014755	MI
2	208000000X	Pediatrics Physician	47304	CO

General Provider Information

NPI Number	:	1750458980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK BENJAMIN ZAMBONI-CUTTER DO

Provider Business Mailing Address
First Line	:	1650 COCHRANE CIR
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80913-4613
Country	:	US
Telephone Number	:	719-526-4899
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 COCHRANE CIR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80913-4603
Country	:	US
Telephone Number	:	719-526-7653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	03/03/2025

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