Provider Demographics
NPI:1033360177
Name:FRANK, MARY SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:SUSAN
Last Name:FRANK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:2111 CHAMPA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2529
Mailing Address - Country:US
Mailing Address - Phone:303-293-2220
Mailing Address - Fax:303-293-3977
Practice Address - Street 1:2130 STOUT STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2529
Practice Address - Country:US
Practice Address - Phone:303-293-2220
Practice Address - Fax:303-293-3977
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO27877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27877OtherSTATE ID NUMBER