Provider Demographics
NPI:1598790198
Name:WINSLOW, MARK C (DO)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:C
Last Name:WINSLOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9259 STAR STREAK CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80125-1891
Mailing Address - Country:US
Mailing Address - Phone:303-856-3568
Mailing Address - Fax:303-648-5709
Practice Address - Street 1:8158 E 5TH AVE STE 220
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7306
Practice Address - Country:US
Practice Address - Phone:303-856-3568
Practice Address - Fax:303-648-5709
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34745204D00000X, 207Q00000X
CO0320000502207PE0004X
CODR.0034745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01347451Medicaid
CO01347451Medicaid