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NPI Code Detail

MEDICARE: DR. MABEL A MARDONES M.D.

MEDICARE: DR. MABEL A MARDONES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianP8274TX
2207RH0003XHematology & Oncology PhysicianP8274TX
3390200000XStudent in an Organized Health Care Education/Training Program
4207RH0003XHematology & Oncology PhysicianDR.0060709CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01800849OTHERTXRAILROAD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134446461
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MABEL A MARDONES M.D.
Provider Business Mailing Address
First Line : 7951 E MAPLEWOOD AVE STE 350
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-4758
Country : US
Telephone Number : 303-930-7895
Fax Number : 832-601-6018
Provider Business Practice Location Address
First Line : 4700 HALE PKWY STE 400
Second Line :
City : DENVER
State : CO
Zip : 80220-4051
Country : US
Telephone Number : 33-210-3023
Fax Number : 303-321-9296
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2010
Last Update Date : 02/17/2025

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