Provider Demographics
NPI:1669457529
Name:THUMIM, MARTIN B (DO)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:B
Last Name:THUMIM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:205 S GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2843
Mailing Address - Country:US
Mailing Address - Phone:303-237-2779
Mailing Address - Fax:303-237-4428
Practice Address - Street 1:205 S GARRISON ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-2843
Practice Address - Country:US
Practice Address - Phone:303-237-2779
Practice Address - Fax:303-237-4428
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO15811207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE05659Medicare UPIN
CO329677YXJDMedicare UPIN