Basic Information
| Provider Information | |||||||||
| NPI: | 1851481527 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AVNER | ||||||||
| FirstName: | MARC | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16830 NORTHGATE DR, SUITE 150 | ||||||||
| Address2: | |||||||||
| City: | PARKER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038057879 | ||||||||
| FaxNumber: | 3038058076 | ||||||||
| Practice Location | |||||||||
| Address1: | 16830 NORTHGATE DR UNIT 150 | ||||||||
| Address2: | |||||||||
| City: | PARKER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801345778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038057879 | ||||||||
| FaxNumber: | 3038058076 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 08/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 44683 | CO | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.