Provider Demographics
NPI:1912093071
Name:MAURER, BRIAN THOMAS (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:THOMAS
Last Name:MAURER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5260
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CO
Mailing Address - Zip Code:81620-5260
Mailing Address - Country:US
Mailing Address - Phone:970-949-0500
Mailing Address - Fax:970-949-0642
Practice Address - Street 1:50 BUCK CREEK ROAD
Practice Address - Street 2:SUITE 205
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620
Practice Address - Country:US
Practice Address - Phone:970-949-0500
Practice Address - Fax:970-949-0642
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO525213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU66546Medicare UPIN