Healthcare Provider Details

I. General information

NPI: 1518316538
Provider Name (Legal Business Name): NATASHA KAZEMIAN MARVI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2356 MEADOWS BLVD STE 340
CASTLE ROCK CO
80109-8410
US

IV. Provider business mailing address

801 YORK ST
MANITOWOC WI
54220-4630
US

V. Phone/Fax

Practice location:
  • Phone: 303-761-7797
  • Fax: 303-789-2995
Mailing address:
  • Phone: 920-663-9008
  • Fax: 920-684-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD492409
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberDR.0077834
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: