Provider Demographics
NPI:1598769358
Name:MASS, ANN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:MASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:225 N MILL ST
Mailing Address - Street 2:STE 116
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1958
Mailing Address - Country:US
Mailing Address - Phone:970-544-1234
Mailing Address - Fax:970-544-1310
Practice Address - Street 1:225 N MILL ST
Practice Address - Street 2:STE 116
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1958
Practice Address - Country:US
Practice Address - Phone:970-544-1234
Practice Address - Fax:970-544-1310
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO21624174400000X
COCO21624207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01216241Medicaid
COC800270Medicare PIN
CO01216241Medicaid