MARK DAVID MENICH (NPI# 1417983438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417983438 |
| Entity Type | Individual |
| Full Name | MARK DAVID MENICH |
| Credential | MD |
| Practice Address |
3950 Broadway St Boulder Valley Asthma and Allergy Clinics Boulder CO 80304-1104 |
| Practice Telephone | 3034445995 |
| Practice Fax Number | 3034435030 |
| Mailing Telephone | 3034445995 |
| Mailing Fax Number | 3034435030 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2015-12-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
46383 | CO | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 46383 | CO | Allopathic & Osteopathic Physicians |
| N | 207RA0201X |
Internal Medicine Specialization: Allergy & Immunology |
MD044657E | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 14209764 | 05 |
| Street Address |
3950 BROADWAY ST BOULDER VALLEY ASTHMA AND ALLERGY CLINICS |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-1104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760429153 | S. Allan Bock | Specialist | 3950 Broadway St, Boulder, CO 80304-1104 | 2006-06-02 |
| 1356941769 | Boulder Valley Asthma & Allergy Clinics | Specialist | 3950 Broadway St, Boulder, CO 80304-1104 | 2020-10-27 |
| 1952522997 | Boulder Valley Asthma & Allergy Clinics, PC | Specialist | 3950 Broadway St, Boulder, CO 80304-1104 | 2007-05-01 |
| 1649217035 | Lloyd D Gelman | Specialist | 3950 Broadway St, Boulder, CO 80304-1104 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 207KA0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Allergy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750365565 | Karen M Andrews | Allergy & Immunology | 2750 Broadway St, Boulder, CO 80304-3573 | 2005-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089538 | William Storms Allergy Clinic PC | Allergy & Immunology | 4535 Milestone Ln, Castle Rock, CO 80104-7918 | 2020-09-25 |
| 1881201754 | William Storms Allergy Clinic PC | Allergy & Immunology | 900 Indiana Ave Ste C, Pueblo, CO 81004-3767 | 2020-09-25 |
| 1013215656 | Nicholas G. Nonas Md Prof LLC | Allergy & Immunology | 2721 S Golden Way, Denver, CO 80227-3845 | 2011-03-07 |
| 1962555458 | Gary Lance Niemann | Allergy & Immunology | 5150 E Yale Cir, S301, Denver, CO 80222-6917 | 2007-01-19 |
| 1205866837 | William A Lanting | Allergy & Immunology | 1029 Robertson St, Fort Collins, CO 80524-3926 | 2006-07-03 |
| 1679573588 | Daniel Fletcher Soteres | Allergy & Immunology | 2709 N Tejon Street, Colorado Springs, CO 80907-6231 | 2005-07-21 |
| 1750389235 | William S Silvers | Allergy & Immunology | 7180 E Orchard Rd, #208, Centennial, CO 80111-1724 | 2005-07-08 |
| 1073120945 | William Storms Allergy Clinic PC | Allergy & Immunology | 9320 Grand Cordera Pkwy Ste 100, Colorado Springs, CO 80924-7004 | 2020-09-25 |
| 1497362362 | William Storms Allergy Clinic PC | Allergy & Immunology | 1263 Lake Plaza Dr Ste 230, Colorado Springs, CO 80906-3512 | 2020-09-25 |
| 1295976769 | Allergy & Asthma Center of The Rockies PC | Allergy & Immunology | 1029 Robertson St, Fort Collins, CO 80524-3926 | 2009-03-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.