Provider Demographics
NPI:1629037395
Name:SAMARIN, FRANK MARK (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:MARK
Last Name:SAMARIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2465 RESEARCH PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920
Mailing Address - Country:US
Mailing Address - Phone:719-265-0100
Mailing Address - Fax:719-265-0101
Practice Address - Street 1:2465 RESEARCH PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-265-0100
Practice Address - Fax:719-265-0101
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2020-12-30
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Provider Licenses
StateLicense IDTaxonomies
CO49667207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COA108836OtherPTAN
CO1699021386Medicaid
CO73232831Medicaid