Individual
DR. MARK D GUADAGNOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 ROCKY MOUNTAIN AVE, STE 100, LOVELAND, CO 80538-9004
(970) 624-1800
(970) 624-1891
Mailing address
2500 ROCKY MOUNTAIN AVE, SUITE 100, LOVELAND, CO 80538-9004
(970) 624-1800
(970) 624-1891
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
29590
CO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
29590
CO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
5495A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01295906
—
CO
05
—
1043208259
—
NE
05
—
111738600
—
WY
01
—
P00970371
RAILROAD MEDICARE
CO
Enumeration date
10/11/2005
Last updated
12/07/2022
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