MEDICARE: MARK EDWARD MAURER

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	213E00000X	Podiatrist	POD.0000717	CO
2	213ES0103X	Foot & Ankle Surgery Podiatrist	SC006125	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891923033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK EDWARD MAURER

Provider Business Mailing Address
First Line	:	1619 N GREENWOOD ST STE 300
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-2657
Country	:	US
Telephone Number	:	719-543-2476
Fax Number	:	719-543-2479

Provider Business Practice Location Address
First Line	:	1619 N GREENWOOD ST
Second Line	:	STE 300
City	:	PUEBLO
State	:	CO
Zip	:	81003-2644
Country	:	US
Telephone Number	:	719-543-2476
Fax Number	:	719-543-2479

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

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	04/08/2026

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Directions to “ MARK EDWARD MAURER ” Practice Location

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