Provider Demographics
NPI:1083752968
Name:WARWICK, MARK CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:CHARLES
Last Name:WARWICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E ESPANOLA ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7519
Mailing Address - Country:US
Mailing Address - Phone:719-475-9535
Mailing Address - Fax:719-634-6169
Practice Address - Street 1:301 E ESPANOLA ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7519
Practice Address - Country:US
Practice Address - Phone:719-475-9535
Practice Address - Fax:719-634-6169
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine