Provider Demographics
NPI:1639240930
Name:SAUNDERS, MARK O (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:O
Last Name:SAUNDERS
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 1:1411 S POTOMAC ST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4536
Mailing Address - Country:US
Mailing Address - Phone:303-695-4800
Mailing Address - Fax:303-695-4821
Practice Address - Street 1:1411 S POTOMAC ST
Practice Address - Street 2:SUITE 450
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4536
Practice Address - Country:US
Practice Address - Phone:303-695-4800
Practice Address - Fax:303-695-4821
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28264174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01282649Medicaid
800885Medicare ID - Type Unspecified
E90293Medicare UPIN