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Individual

MARY BERNADETTE KENNY MOYNIHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7444 W ALASKA DR, STE 250, LAKEWOOD, CO 80226-3327
(303) 592-7284
(303) 892-0601
Mailing address
7444 W ALASKA DR, STE 250, LAKEWOOD, CO 80226-3327
(303) 592-7284
(303) 892-0601

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34459
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
94287091
CO
Enumeration date
10/03/2005
Last updated
11/20/2007
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