Individual
MARC ANTHONY MASOTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401A UNION ST, JOHNSTOWN, CO 80534-2800
(801) 783-5011
(801) 746-3734
Mailing address
PO BOX 3299, CARSON CITY, NV 89702-3299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9498
NM
208M00000X
Hospitalist Physician
94-98
NM
208M00000X
Hospitalist Physician
Primary
DR.0053289
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08639779
—
NM
01
—
1380580
UHC
—
01
—
202019599
PRESBYTERIAN HEALTH PLANS
—
01
—
NM002A17
BCBS NM
NM
01
—
QMP000003390487
MOLINA
—
Enumeration date
08/07/2006
Last updated
08/19/2020
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