Provider Demographics
NPI:1447282603
Name:BERSENTES, KORINA R (MD)
Entity type:Individual
Prefix:DR
First Name:KORINA
Middle Name:R
Last Name:BERSENTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:936 SHAVANO PEAK DR
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-6084
Mailing Address - Country:US
Mailing Address - Phone:303-912-8948
Mailing Address - Fax:303-494-5264
Practice Address - Street 1:936 SHAVANO PEAK DR
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-6084
Practice Address - Country:US
Practice Address - Phone:303-912-8948
Practice Address - Fax:303-494-5264
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO36175207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO100009897OtherRAILROAD MEDICARE
CO01361757Medicaid
COBEA1368OtherBCBS
COCA1368Medicare PIN
COBEA1368OtherBCBS