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NPI Code Detail

MEDICARE: MARK PEREA MD PC

MEDICARE: MARK PEREA MD PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician37293CO

General Provider Information

NPI Number : 1063541969
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARK PEREA MD PC
Provider Business Mailing Address
First Line : 9894 ROSEMONT AVE STE 103
Second Line :
City : LONE TREE
State : CO
Zip : 80124-4103
Country : US
Telephone Number : 303-792-0799
Fax Number :
Provider Business Practice Location Address
First Line : 9894 ROSEMONT AVE STE 103
Second Line :
City : LONE TREE
State : CO
Zip : 80124-4103
Country : US
Telephone Number : 303-792-0799
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MARK PEREA
Credential : M.D.
Telephone Number : 303-792-0799
Provider Enumeration Date : 03/05/2007
Last Update Date : 08/22/2020

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