MEDICARE: DR. MARC T AVNER M.D.

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
1	208000000X	Pediatrics Physician	44683	CO

General Provider Information

NPI Number	:	1851481527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC T AVNER M.D.

Provider Business Mailing Address
First Line	:	16830 NORTHGATE DR, SUITE 150
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134
Country	:	US
Telephone Number	:	303-805-7879
Fax Number	:	303-805-8076

Provider Business Practice Location Address
First Line	:	16830 NORTHGATE DR UNIT 150
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-5778
Country	:	US
Telephone Number	:	303-805-7879
Fax Number	:	303-805-8076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	08/17/2021

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