Provider Demographics
NPI:1295934081
Name:MARINO, DOREEN TELISAK (MD)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:TELISAK
Last Name:MARINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DOREEN
Other - Middle Name:ANN
Other - Last Name:TELISAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1400 S POTOMAC ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4528
Mailing Address - Country:US
Mailing Address - Phone:303-745-0000
Mailing Address - Fax:303-745-1299
Practice Address - Street 1:1400 S POTOMAC ST
Practice Address - Street 2:SUITE 110
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4528
Practice Address - Country:US
Practice Address - Phone:303-745-0000
Practice Address - Fax:303-745-1299
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113085208M00000X
CO45811207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist