Provider Demographics
NPI:1790789105
Name:WARNER, MARY L (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:WARNER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1400 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-2761
Mailing Address - Country:US
Mailing Address - Phone:303-388-4461
Mailing Address - Fax:303-398-1211
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:STE 300
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2793
Practice Address - Country:US
Practice Address - Phone:303-788-8500
Practice Address - Fax:303-788-8505
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-03-17
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Provider Licenses
StateLicense IDTaxonomies
CO33853207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01338532Medicaid
CO811223Medicare PIN
COG47955Medicare UPIN