Healthcare Provider Details

I. General information

NPI: 1619022738
Provider Name (Legal Business Name): ANNE MARIE O'MELIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8199 E 1ST AVE
DENVER CO
80230-7163
US

IV. Provider business mailing address

7351 E LOWRY BLVD STE 200
DENVER CO
80230-6083
US

V. Phone/Fax

Practice location:
  • Phone: 720-370-8260
  • Fax:
Mailing address:
  • Phone: 720-214-4623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number346254-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35091989
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD61026284
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number036146973
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0088583
License Number StateMD
# 6
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberCDRH0054342
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: