Provider Demographics
NPI:1215986476
Name:ROTMAN, MARK F (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:F
Last Name:ROTMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1300 RIVERSIDE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4351
Mailing Address - Country:US
Mailing Address - Phone:970-224-1670
Mailing Address - Fax:970-495-6218
Practice Address - Street 1:2001 S SHIELDS ST BLDG I
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1827
Practice Address - Country:US
Practice Address - Phone:970-221-5255
Practice Address - Fax:970-221-5206
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2021-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO31025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01310259Medicaid
COE92763Medicare UPIN
CO01310259Medicaid