Individual
DR. MARY A BLATTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5881 W 16TH ST, GREELEY, CO 80634-2910
(970) 313-2734
(970) 313-2733
Mailing address
5881 W 16TH ST, GREELEY, CO 80634-2910
(970) 313-2734
(970) 313-2733
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
22983
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01229830
—
CO
01
—
P00944855
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
12/30/2005
Last updated
07/01/2013
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