Individual
DR. STEPHEN JAD MAZURKIVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
(719) 524-2273
Mailing address
4102 PINION DR, USAF ACADEMY, CO 80840-2502
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101272254
VA
207R00000X
Internal Medicine Physician
DR.0070074
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029548
KAISER COMMERCIAL NUMBER
CO
05
—
9000214261
—
CO
Enumeration date
03/29/2019
Last updated
05/10/2024
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