Healthcare Provider Details

I. General information

NPI: 1952507667
Provider Name (Legal Business Name): SUZANNE MELA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 11/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 S COLORADO BLVD SUITE A
DENVER CO
80246-1954
US

IV. Provider business mailing address

1460 LITTLE RAVEN STREET
DENVER CO
80202-1406
US

V. Phone/Fax

Practice location:
  • Phone: 303-692-8000
  • Fax:
Mailing address:
  • Phone: 914-309-7771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR0047766
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number47766
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: