Organization
PHILIP C. MARIN, MD PROF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP C. MARIN MD (OWNER)
(719) 565-1000
Entity
Organization
Contact information
Practice address
650 DITTMER AVE, PUEBLO, CO 81005-1212
(719) 565-1000
(719) 565-1111
Mailing address
650 DITTMER AVE, PUEBLO, CO 81005-1212
(719) 565-1000
(719) 565-1111
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
40500
CO
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
40500
CO
Other
Enumeration date
10/25/2007
Last updated
10/25/2007
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