Individual
MARK S. FASZHOLZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 350-4819
Mailing address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 350-4819
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
36370
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202748166
—
MO
Enumeration date
01/11/2006
Last updated
04/25/2011
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