Provider Demographics
NPI:1851481527
Name:AVNER, MARC T (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:T
Last Name:AVNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16830 NORTHGATE DR, SUITE 150
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134
Mailing Address - Country:US
Mailing Address - Phone:303-805-7879
Mailing Address - Fax:303-805-8076
Practice Address - Street 1:16830 NORTHGATE DR UNIT 150
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5778
Practice Address - Country:US
Practice Address - Phone:303-805-7879
Practice Address - Fax:303-805-8076
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO44683208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics