Healthcare Provider Details

I. General information

NPI: 1124439849
Provider Name (Legal Business Name): MELISSA PAULA HURWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9255 W ALAMEDA AVE STE F
LAKEWOOD CO
80226-2802
US

IV. Provider business mailing address

9255 W ALAMEDA AVE STE F
LAKEWOOD CO
80226-2802
US

V. Phone/Fax

Practice location:
  • Phone: 303-233-9107
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD.0000926
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD.0000926
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: