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General NPI Number Information
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NPI Number | 1982694683
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Entity Type | Individual
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Provider Name | PETER MARLIN MD
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Gender | Male
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 2860 S CIRCLE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4113
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Country | US
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Telephone | 719-540-2146
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Fax |
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Provider Business Mailing Address
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Address Line | 2860 S CIRCLE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-4113
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Country | US
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Telephone | 719-922-1882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 12873
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DR.0066406
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License Number State | CO
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