Provider Demographics
NPI:1245420892
Name:MARC A. SINDLER, MD
Entity Type:Organization
Organization Name:MARC A. SINDLER, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:A
Authorized Official - Last Name:SINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-275-4137
Mailing Address - Street 1:215 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-3216
Mailing Address - Country:US
Mailing Address - Phone:719-275-4137
Mailing Address - Fax:
Practice Address - Street 1:215 N 5TH ST
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-3216
Practice Address - Country:US
Practice Address - Phone:719-275-4137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04006458Medicaid