Healthcare Provider Details

I. General information

NPI: 1740257153
Provider Name (Legal Business Name): MARY ZAVADIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 MARION
DENVER CO
80218
US

IV. Provider business mailing address

1625 MARION
DENVER CO
80218
US

V. Phone/Fax

Practice location:
  • Phone: 303-830-7337
  • Fax: 303-830-1890
Mailing address:
  • Phone: 303-830-7337
  • Fax: 303-830-1890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number29689
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: