Individual
DR. MARY E VIERTHALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1925 MOUNTAIN VIEW AVE FL 3, LONGMONT, CO 80501-3128
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
DR.0040396
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20489056
—
CO
01
—
C475978
MEDICARE PTAN
CO
Enumeration date
11/18/2005
Last updated
10/06/2021
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