Provider Demographics
NPI:1558439760
Name:BARTER, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:BARTER
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 1:8510 BRYANT ST STE 340
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3852
Mailing Address - Country:US
Mailing Address - Phone:720-872-2321
Mailing Address - Fax:303-451-9244
Practice Address - Street 1:8510 BRYANT ST STE 340
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3852
Practice Address - Country:US
Practice Address - Phone:720-872-2321
Practice Address - Fax:303-451-9244
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20374174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01203744Medicaid
COD23771Medicare UPIN
CO6931Medicare ID - Type Unspecified