Individual
TIMOTHY MICHAEL BRESNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 FAIRHURST ST, STERLING, CO 80751-4523
(970) 522-0122
Mailing address
PO BOX 804, MANITOU SPRINGS, CO 80829-0804
(720) 261-5141
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43658
CO
208M00000X
Hospitalist Physician
12734
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12734
MT LICENSE
MT
01
—
43658
CO LICENSE
CO
05
—
71330089
—
CO
Enumeration date
07/10/2006
Last updated
03/06/2021
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