MEDICARE: MARK MAURATH

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	171M00000X	Case Manager/Care Coordinator
2	1041C0700X	Clinical Social Worker	CSW.09930029	CO

General Provider Information

NPI Number	:	1821545682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK MAURATH

Provider Business Mailing Address
First Line	:	1200 SAINT PAUL ST # R-02
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-3351
Country	:	US
Telephone Number	:	614-288-3839
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 SAINT PAUL ST # R-02
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-3351
Country	:	US
Telephone Number	:	614-288-3839
Fax Number	:

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

Provider Enumeration Date	:	09/08/2016
Last Update Date	:	05/29/2024

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