Provider Demographics
NPI:1588607816
Name:HUSNEY, MARY CATHERINE W (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY CATHERINE
Middle Name:W
Last Name:HUSNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4999 E KENTUCKY AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-3901
Mailing Address - Country:US
Mailing Address - Phone:720-770-8199
Mailing Address - Fax:720-770-8399
Practice Address - Street 1:4999 E KENTUCKY AVE STE 103
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-3901
Practice Address - Country:US
Practice Address - Phone:720-770-8199
Practice Address - Fax:720-379-5319
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41315207Q00000X
COCO41315207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO93179065Medicaid
COAAA2668Medicare PIN
I04709Medicare UPIN
COAAA2667Medicare PIN