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Individual

DR. MAREK A ODEHNAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(720) 494-3126
(720) 718-8025
Mailing address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(720) 494-3126
(720) 718-8025

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01060578
IN
207R00000X
Internal Medicine Physician
Primary
DR.0053285
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200807010A
IN
05
30103886
CO
Enumeration date
03/22/2006
Last updated
11/05/2021
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