Individual
MICHAEL MARTUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2121 E HARMONY RD UNIT 290, FORT COLLINS, CO 80528-3402
(970) 221-2370
(970) 221-9654
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
9767A
WY
207K00000X
Allergy & Immunology Physician
Primary
DR.0048242
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10027065300
—
NE
05
—
135469800
—
WY
05
—
30928371
—
CO
01
—
391620ZMHC
MEDICARE PTAN
CO
01
—
W27146
MEDICARE PTAN
WY
Enumeration date
05/11/2007
Last updated
10/18/2023
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