Provider Demographics
NPI:1831388008
Name:ANN M. MASS, M.D., P.C.
Entity type:Organization
Organization Name:ANN M. MASS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:MASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-544-1234
Mailing Address - Street 1:225 N MILL ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1559
Mailing Address - Country:US
Mailing Address - Phone:970-544-1234
Mailing Address - Fax:970-544-1310
Practice Address - Street 1:225 N MILL ST
Practice Address - Street 2:SUITE 116
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1559
Practice Address - Country:US
Practice Address - Phone:970-544-1234
Practice Address - Fax:970-544-1310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21624207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01216241Medicaid
CO01216241Medicaid
COC800269Medicare PIN