Provider Demographics
NPI:1760961684
Name:MONUMENT MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:MONUMENT MEDICAL ASSOCIATES, PC
Other - Org Name:MONUMENT MEDICAL ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJMUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-313-8401
Mailing Address - Street 1:1150 W BAPTIST RD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-2480
Mailing Address - Country:US
Mailing Address - Phone:719-445-9852
Mailing Address - Fax:719-426-9796
Practice Address - Street 1:1150 W BAPTIST RD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-2480
Practice Address - Country:US
Practice Address - Phone:719-445-9852
Practice Address - Fax:719-426-9796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center