Provider Demographics
NPI:1952519308
Name:SAWYER, MARK D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:SAWYER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12631 E 17TH AVE STE C305
Mailing Address - Street 2:UC ANSCHUTZ MEDICAL CENTER, DIVISION OF UROLOGY
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2527
Mailing Address - Country:US
Mailing Address - Phone:720-331-6645
Mailing Address - Fax:303-724-2761
Practice Address - Street 1:12631 E 17TH AVE STE C305
Practice Address - Street 2:UC ANSCHUTZ MEDICAL CENTER, DIVISION OF UROLOGY
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2527
Practice Address - Country:US
Practice Address - Phone:720-331-6645
Practice Address - Fax:888-250-6983
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2015-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH57.009404208800000X
TNMD0000046244208800000X
VA0101251164208800000X
CODR.0054556208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952519308Medicaid
VA1952519308Medicare PIN