Provider Demographics
NPI:1740257526
Name:MUSHINSKY-TRALLES, ANN V (MD)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:V
Last Name:MUSHINSKY-TRALLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:61 INVERNESS DR EAST STE 200
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112
Mailing Address - Country:US
Mailing Address - Phone:303-561-5100
Mailing Address - Fax:303-397-2112
Practice Address - Street 1:2551 W 84TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3807
Practice Address - Country:US
Practice Address - Phone:303-561-5010
Practice Address - Fax:303-561-5050
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO29955207R00000X
CODR.0029955207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200088590AMedicaid
KS200389150AMedicaid
WY122160400Medicaid
CO01299551Medicaid
COQ2238Medicare ID - Type Unspecified
WY122160400Medicaid