Provider Demographics
NPI:1225092414
Name:PEREA, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:PEREA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1707 COLE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3220
Mailing Address - Country:US
Mailing Address - Phone:303-716-8013
Mailing Address - Fax:303-763-5495
Practice Address - Street 1:9695 S YOSEMITE ST
Practice Address - Street 2:STE 324
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2888
Practice Address - Country:US
Practice Address - Phone:303-706-9054
Practice Address - Fax:303-302-9799
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2013-10-04
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Provider Licenses
StateLicense IDTaxonomies
CO37293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine