Provider Demographics
NPI:1124089107
Name:BERLAND, MARK P (DO)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:P
Last Name:BERLAND
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1550 S POTOMAC ST
Mailing Address - Street 2:SUITE 135
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5455
Mailing Address - Country:US
Mailing Address - Phone:303-369-1019
Mailing Address - Fax:303-369-1062
Practice Address - Street 1:1550 S POTOMAC ST
Practice Address - Street 2:SUITE 135
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5455
Practice Address - Country:US
Practice Address - Phone:303-369-1019
Practice Address - Fax:303-369-1062
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2007-12-07
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Provider Licenses
StateLicense IDTaxonomies
CO20912207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01209121Medicaid
CO01209121Medicaid
COD23852BEMedicare UPIN