Organization
RED MOUNTAIN INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY MICHAEL BRESNAHAN MD (AUTHORIZED OFFICIAL)
(720) 261-5141
Entity
Organization
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
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43658
CO LIC
CO
Enumeration date
04/26/2010
Last updated
03/06/2021
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