Individual
DR. SAMUEL JAMES MAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2950 E HARMONY RD, FORT COLLINS, CO 80528-3419
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-3339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0053404
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01607201
—
CO
01
—
029209
KAISER COMMERCIAL NUMBER
CO
Enumeration date
06/21/2011
Last updated
04/16/2021
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