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Individual

DR. MARK WILLIAM LANDMEIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2121 E HARMONY RD, SUITE 300, FORT COLLINS, CO 80528-3400
(970) 224-9102
(970) 224-9112
Mailing address
2121 E HARMONY RD, SUITE 300, FORT COLLINS, CO 80528-3400
(970) 224-9102
(970) 224-9112

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036127664
IL
207R00000X
Internal Medicine Physician
DR.0057189
CO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
DR.0057189
CO
207RP1001X
Pulmonary Disease Physician
Primary
DR.0057189
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036127664
IL
01
206147
MEDICARE PTAN (GROUP)
IL
01
206147114
MEDICARE PTAN (INDIVIDUAL)
IL
01
CA4748
RAILROAD MEDICARE PTAN (GROUP)
IL
01
P01089934
RAILROAD MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
07/20/2008
Last updated
08/02/2016
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