Healthcare Provider Details

I. General information

NPI: 1043293350
Provider Name (Legal Business Name): MELISSA KAY EWER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9480 BRIAR VILLAGE PT SUITE 200
COLORADO SPRINGS CO
80920-7922
US

IV. Provider business mailing address

PO BOX 110429
AURORA CO
80042-0429
US

V. Phone/Fax

Practice location:
  • Phone: 719-278-3627
  • Fax: 719-623-2101
Mailing address:
  • Phone: 303-493-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number44097
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberDR.0044097
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: