Provider Demographics
NPI:1396931465
Name:PAZ, FREDERICK MARK (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:MARK
Last Name:PAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 INDIANA ST STE 280
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5069
Mailing Address - Country:US
Mailing Address - Phone:303-985-1811
Mailing Address - Fax:303-985-3917
Practice Address - Street 1:400 INDIANA ST STE 280
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5069
Practice Address - Country:US
Practice Address - Phone:303-985-1811
Practice Address - Fax:303-985-3917
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29958207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty