Provider Demographics
NPI:1609864065
Name:BENDER, JOHN LUMIR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LUMIR
Last Name:BENDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3850 GRANT AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8431
Mailing Address - Country:US
Mailing Address - Phone:970-482-0213
Mailing Address - Fax:970-482-9646
Practice Address - Street 1:4674 SNOW MESA DR
Practice Address - Street 2:SUITE 140
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-8615
Practice Address - Country:US
Practice Address - Phone:970-482-0213
Practice Address - Fax:970-482-9646
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2013-06-18
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Provider Licenses
StateLicense IDTaxonomies
CO32679207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF68188Medicare UPIN
CO452578Medicare PIN