Healthcare Provider Details

I. General information

NPI: 1447399464
Provider Name (Legal Business Name): MARTIN DINGES MOLANDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MARTIN MATTHEW DINGES MD

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 N FRANKLIN ST
DENVER CO
80205-5437
US

IV. Provider business mailing address

10350 E DAKOTA AVE
DENVER CO
80247-1314
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberM-10708
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberM-10708
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number46671
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: