Healthcare Provider Details

I. General information

NPI: 1366579245
Provider Name (Legal Business Name): MARK A HUUN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 11/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 WAZEE ST SUITE D
DENVER CO
80202-1478
US

IV. Provider business mailing address

4900 S MONACO ST #210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-534-9550
  • Fax: 720-932-7805
Mailing address:
  • Phone: 303-534-9550
  • Fax: 720-932-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number30960
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: