Individual
ERIC D MAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
205 S. MAIN ST., SUITE B, LONGMONT, CO 80501-1714
(303) 772-6244
(303) 702-1623
Mailing address
205 S. MAIN ST., SUITE B, LONGMONT, CO 80501-1714
(303) 772-6244
(303) 702-1623
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54581
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46125086
—
CO
Enumeration date
07/14/2011
Last updated
04/06/2017
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